The Final Report for Unclogging the Blockages is here!  See the link below to download the report via Google Drive.  Interested in learning more?  Were you an organizer and you'd like to discuss the findings?  Stay tuned for a future skype meeting to get everyone together to discuss the report and the next steps to #unclogit.

Unclogging the Blockages 2014: Final Report 

If you have any issues accessing the report, please reach out to jsauer@waterforpeople.org and he can send you a version via email.

Additionally, a huge thanks to our partner SuSanA who have created a page with not only the final report, but who have compiled many presentations, speeches, photos and articles from the workshop.  Check out the page here: SuSanA Unclogging the Blockages to see more.

Many thanks to everyone who contributed!

Nature Calls: Kampala's Overflowing Toilets

Sam Loewenberg, a reporter whose travel to Uganda was funded by the Pulitzer Prize Center on Crisis Reporting, describes the current situation for fecal sludge management in Kampala in his article published by Aljazeera America.  An excerpt is below -- read the full story here:
http://america.aljazeera.com/articles/2014/3/21/nature-calls-kampalasoverflowingtoilets.html

KAMPALA, Uganda — For many Americans, the idea of waiting even one day to get their toilet fixed is unbearable. Last month Florence Asiimwe, a mother of three who lives in the Bwaise Kazo zone of Kampala, had to wait six weeks for hers to be serviced. In the meantime, her family used a neighbor’s facilities. On the day the latrine was finally being fixed, she said simply, “I am very happy,” and went back to washing her laundry on the stoop of her small brick home.

 Asiimwe’s long wait will be familiar to the residents of Bwaise Kazo, one of the biggest and oldest slums in Uganda’s capital. According to the Kampala Capital City Authority, more than 70 percent of the city’s 1.3 million people rely on pit latrines, or outhouses. But pit latrines fill up. It might take six months or a few years, depending on where they were built, how well they drain and how many people use them, but they will fill up. And in 2015, an estimated 10 percent will be full.

The problem is that in the overbuilt patchwork of brick and scrap-metal houses that make up the slums, there is no easy way to empty the latrines. People make do but not very well. There is water, but the supply is inconsistent, and the slum dwellers pay 10 times as much for their water than do people with piped water in their homes. There are roads, but they are not paved. There are latrines, but they fill up. Sewage removal trucks cannot navigate the narrow dirt and mud streets, and most people could not afford them anyway.

Hence the Gulper, a two-meter-long PVC and stainless steel hand pump used to empty latrines. As Asiimwe does her laundry, her 2-year-old boy, David, is out back, watching as two men in blue uniforms pump out the latrine sludge into plastic canisters, which they then load onto a truck to take to Kampala’s only sewage treatment plant, in Bugolobi, about a mile from the city center. The smell as they remove the sludge is nauseating, but the process appears fairly clean, all things considered.

 The idea of turning sanitation into a small business in Kampala originated with Water for People, a Denver-based nonprofit that brought the Gulper to the city by contracting with a local manufacturer to make and sell it. The group fosters grass-roots water and sanitation projects in eight other African and Latin American countries. Water for People recruited and trained entrepreneurs who wanted to start Gulper businesses. Now the nonprofit is working with the entrepreneurs to try to set up an association and certification scheme. After just one year, the businesses in Kampala are self-sustaining or at least trying to be.

British engineer Steven Sugden, who now works for Water for People, invented the Gulper while doing research at the London School of Hygiene and Tropical Medicine in 2003. Though the manually operated pump is a simple piece of equipment, it has succeeded where trucks and big infrastructure have failed, and in bringing accessibility and relative affordability to sludge removal, the new technology has made sanitation available to Kampala residents like Asiimwe. 

After years of working on a range of technocratic and bureaucratic schemes in community sanitation, Sugden says this free-market approach of Gulper entrepreneurs seems to work best. “I’ve come to sanitation as a business not because it is the perfect solution but because everything else I’ve tried has failed,” he says. “We try and have as light a touch as possible, as we know the risks of NGO involvement screwing up the market. We want to remain invisible so we can disappear completely when the market starts to mature.”

The Disease With No Borders

The Pulitzer Prize Center on Crisis Reporting sponsored journalist Sam Loewenberg to travel to Uganda to cover the Unclogging event.  Below is an excerpt from his article, which can be found here:
 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60817-5/fulltext

Uganda's struggle with schistosomiasis

Sam Loewenberg

Sanitation is not just a rural problem. In Kampala, only 5% of the city has sewage coverage—mostly wealthy residential and business districts. Much of the rest of the population has to rely on pit latrines. In the crowded housing and unpaved roads of the slums, trucks cannot get access, so the latrines fill up within a few years and are then not emptied. Not only do they then become unusable, they often overflow when it rains. So residents are forced to illegally empty their latrines into open gutters.In the Kiswa Health Center, a public clinic in Kampala that serves more than 3300 patients, the effect of NTDs is overwhelming. The clinic receives about 120 cases of diarrhoeal disease a month, when it should be about ten, says a nurse who asked that her name not be used. Worm infestation is at 100 per month, about 20 times too high, since they have a deworming programme, she says. They receive about two severe cases of malnutrition a day, she says. They also had three new cases of tuberculosis in one day, and have seen two cases of multidrug resistant tuberculosis. HIV is also making a resurgence.
The wealthy sectors of Ugandan society, including corporations, need to take part in funding sanitation initiatives because local governments do not have enough funding, says Godfrey Kisekka, one of Kampala's town clerks. “We need to sensitise the rich that the health of the poor matters to them. Disease has no borders.”

It's Easy to Flush and Forget.

Jailan Adly, Director of MBAs Without Borders, a panelist and attendant of the workshop, wrote an excellent piece (Part 1 of a three-part series) on her experience at Unclogging the Blockages. Click here to read more:  Part I: How an Ambitious Group of Innovators are Catalyzing Change in the Toilet Business

Uganda Broadcasting Coporation: TV Coverage of #unclogit

Photos Now Up on Facebook!

Please visit The Sanitation as a Business Facebook Page to see hundreds of photos from the workshop.  If you spot you or someone you know, please feel free to tag yourself and share with others!

Day 3: Unclogging the Blockages

It’s easy to talk shit.  Which is to say, it’s not difficult to identify challenges within sanitation programs; there are many.  What’s difficult is to find the root of those challenges and then develop a viable plan to address them and ultimately move the sector forward.

Day 3 of the Unclogging Blockages conference, the final day, forced participants to think practically and critically about the solutions they were proposing.  What is actionable?  What has been done before?  Where can we collaborate with others?  What is beyond our capacity?  Why is each step necessary?

Satya Chaubey of PSI India was lead facilitator for the team assigned the task of designing a solution to improve consumer and enterprise-level financing.  Unlike traditional donor funding for implementing an entire program, this level of finance is lent to individual households and businesses – most commonly known as microfinance loans.  Over the course of Day 3 and with regular feedback from other workshop participants, Satya's team outlined their action plan: create a Global Sanitation Financing Alliance at the international donor level that provides financing at the local level. They gave specific tasks to be completed, all the way down to, "write a concept note" and called upon workshop participants to commit themselves or their organizations to assist with the completion of that task.

By outlining a clear pathway forward, this week's teams have taken the typical conference to a new level. It's not enough to know the problems and suggest solutions; we need to take action to Unclog the Blockages.

Thoughts from IRC

Guest post by Marielle Snel of IRC
It is amazing that we are already on the last day of the mega interesting conference on “Unclogging the blockages in sanitation”. The IRC, whom are one of the co-facilitators of this conference, clearly see a role for itself here in terms of being the knowledge bridge in linking the public and private sector around sustainable sanitation. http://www.source.irc.nl/page/82052

As IRC we see that sanitation is not only a private good, but also a public good and a public right. The health, environmental and socio-economic benefits of improved sanitation and hygiene practices are the most compelling arguments for public sector measures (establishing a policy and legislative framework, setting standards and rules of the game, planning, financing, coordination but also regulation and oversight with respect to the whole sanitation chain) to enable, facilitate and promote  improved sanitation.

What we see here at this conference, is an interesting audience (more than 200 persons) focusing on how better to link the public and the private sector. Clearly we have a way to go…but what better way than to be here together focusing on one of the cutting edge areas of where our sanitation efforts need to move ,in order to create sustainable sanitation for all forever!

Day 2: Loosening the Bockages

After an information-packed day of presentations and discussions to better understand the current situation and learn from each other’s experience in markets for sanitation, Day 2, Loosening the Blockages took on an entirely different mood: it’s time to think outside the box, be innovative and apply the lessons we’ve learned to addressing the key blockages.  

The technology team prioritizes the challenges they'll address

Throughout Day 1, participants were encouraged to write down challenges they had identified during the presentations and panel discussions.  They then posted these challenges on flip charts placed around the room, based on the seven thematic areas: Finance, Business Models, Public Sector, Technology, Monitoring, Behavior Change and Intersectoral Links.  On the morning of Day 2, groups for each thematic area were given the task of cleaning up and whittling down the challenges identified by everyone in attendance, and to expand upon the best ideas.  This exercise was repeated throughout the day: brainstorm, then whittle, brainstorm, then whittle.   

After various exercises to get participants thinking quickly and innovatively, the final result was that each of the groups had taken the challenges identified in Day 1, prioritized them, and then developed a solution comprised of the key components.

The Intersectoral Team brainstorms their dream outcome

“Our goal is that one day every household will describe the bathroom as their favorite room of the house!” declared Yi Wei of International Development Enterprises (iDE) in Cambodia.  Groups were told to come up with catchy – sometimes wacky – headlines for their ideas, to dream big and believe in the workshop’s potential to spark real change within the sanitation sector. 

The activities of Day 2 were designed to harness the power of having so many distinct occupations, personalities and nationalities together in one place; to pull from the diversity of experiences to produce solutions that address markets for sanitation at a global, cross-sectoral level. 

Many of the solutions proposed call for better collaboration: more workshops, global networking, uniform monitoring standards, knowledge sharing and more involvement with the public sector.  From a 30-day challenge to design an end-to-end solution ready for scale, to the Global Sanitation Financing Alliance for donors to collaborate on financing for the consumer level, the solutions are both practical and aspirational.

Just like a toilet should be.

Uganda: Shit is not just a poor man’s problem

Guest Post by Rosebell Kagumire 
A while back, a friend returned from a funeral of one the big men from his village. The man had served as a minister in one of past regimes and had generally lived a good life. My friend’s story from the big man’s funeral wasn’t about the pomp, which many often try to put up even at funerals in our rich world. It was about one shocking aspect of the man’s life. This big man had lived in Kampala and kept his village home like most Ugandans do but to the surprise of my friend this big man’s village home where he was buried had had no toilet/latrine facilities. The only standing structure had been quickly erected at the news of his passing. I was reminded of this story at a sanitation meeting that is taking place in Kampala, which brought participants from 21 countries.

When I first saw the theme“unclogging the blockages” I wondered if we had even anything blocked in the first place. Contrary to held myths that open-air defecation is done by poor people, this story of the big man shows that shit matters in Uganda are everyone’s problem.

A Wateraid photo of a slum near Makerere University

Sanitation and especially disposal of human waste many times is not a priority even when people have money. In a country where 75% of the disease burden are preventable and sanitation related, we cannot simply relegate this problem to just a poor person’s problem. And because it is shaped as something distant in some slums and villages, like many problems of these areas, sanitation is the last on our government’s priority list. Our government annually spends Ushs 30 billion on treatment of sanitation related diseases but does little to provide the sanitation support- a preventive measure that would save our tax money.

In the last quarter the government spent only Ushs 5.5 million for sanitation but it will fork out 30 billon by end of the year to treat Ugandans. With corruption that has eaten away most of the systems and in a world where politics rule we can hardly implement even by-laws to ensure Ugandans meet sanitation standards that are well written in our policies.

Julian Kyomuhangi, an assistant commissioner in the Ministry of Health told this gathering that the politics had crippled enforcement of by-laws that aim to tackle open-air defecation. “We started enforcement to get Ugandans to build latrines and we were able to increase latrine coverage by 5% in a short time but we didn’t go far because some people came and said we were disturbing their voters.”  Incredible! These so called ‘some people’ are the leaders who stifle most of development by affirming ridiculous rights to their voters including the right to defecate wherever one feels like!

Thanks partly to such politics, about 3.2 million Ugandans have no latrine at all and still defecate in the open. In Kampala, only 12% of population about 2 million people is connected to a sewer line. An Engineer from GIZ Fredrick Tumusiime told the meeting we don’t expect sewerage sanitation to increase even by 25% in Kampala in next 20yrs.

Dr. Ruhakana Rugunda, Minister of Health told the meeting Uganda is lagging behind in achieving sanitation and water MDGs and it is about time we began talking about sanitation and its value and impact on the economy.

Dr. Ruhukana Rugunda, Minister of Health

 According to the Water and Sanitation Program (WSP), 13.8 million Ugandans use unsanitary or shared latrines. In primary schools the latrine to pupil ratio is 1:70, meaning at one break time, about 70 kids line up to use one toilet!

Natural disasters like floods and landslides have increased sanitation challenges.

Mr. Martin Eyura, Soroti District Environmental Health Officer told the meeting that 3/4 of the district experiences floods during rainy seasons. Floods usually take the poorly constructed latrines which increases diseases.

And the other damning statistic, only 29% of Ugandans wash hands with soap after toilet. Many I spoke to believe even this figure is on the high side because people are not always fully truthful about such an issue.

This meeting has brought together people working in sanitation sector to look at furthering sanitation as a business. Clearly, the government alone cannot provide the much-needed services but at the same time businesses cannot be a solution if the government isn't giving much attention to the issue. In the next post I will divulge into various solutions presented here.

Rosebell is a World Economic Forum Young Global Leader and blogger and is attending the #unclogit workshop.  She is sharing regular updates on Twitter, follow her at @RosebellK and check out her website rosebellkagumire.com

Day 1: Understanding the Blockages

With nearly 170 participants registered, 21 countries represented, countless organizations and specialties and the loud buzz of excited conversation, the first ever Unclogging the Blockages got off to a great start.

Jane Nabunnya, IRC welcomes the participants

Today's goal was to Understand the Blockages: an entire day dedicated to informing participants of the challenges faced within the sanitation sector.  Using both panel discussions and rotating group presentations (called the World Café), individuals and organizations, from microfinance providers to corporations to technical programmers, were able to describe their role in sanitation as a business, and the key challenges they have faced.  Only by sharing experiences and helping each other to understand the barriers we each face, can we then identify the key blockages that are affecting the sanitation sector as a whole.


"We need to be practical, we need to think at scale, and we need to think in context."  Clara Rudholm of the Water Supply and Sanitation Collaborative Council (WSSCC) kicked off the workshop with these important guidelines.  Later in the day, the workshop had the honor to host Dr. Ruhakana Rugunda, the Uganda Minister of Health, who expressed his strong support, and made it clear that the Ugandan government eagerly awaits the findings and recommendations of the workshop.  Recognizing each of the countries present, Dr. Rugunda compelled the participants to share their findings worldwide, particularly with policy makers like him.

Steven Sugden, Water For People, discusses technology

The goal of Day 1 was to make sure that each of the participants had an opportunity to learn about the challenges faced in market-based approaches to sanitation among a wide variety of actors.  Mike Khoza of Plan International described a village level banking project that organizes savings groups for household toilets.  He explained the challenge Plan faced with keeping money moving and ensuring that payments are being made and not simply pooled into an account.  William Lin of Johnson & Johnson Worldwide Corporate Contributions spoke on a panel discussion.  He explained that he's new to the sanitation space, but that he recognizes great potential for J&J to increase its impact and use its corporate experience for social good to improve markets for sanitation.  From a village savings group to a multi-national corporation, the participants at the Unclogging workshop represent a diverse set of experiences.

After many engaging discussions, hard-hitting questions and thoughtful reflection, the first day of Understanding the Blockages was a success.  Participants left with a deep understanding of the challenges faced in the creation of sustainable, efficient and effective businesses for sanitation.  Tomorrow: Loosening the Blockages!

Time to Start Unclogging!

Despite growing attention to sanitation being paid by donors and governments, and the declaration by the United Nations that access to basic sanitation is a human right, progress remains slow.

In an effort to get things moving (pun intended), on Tuesday, February 18, the first ever Unclogging the Blockages in Sanitation workshop commenced in Kampala, Uganda. (The sector knows no limit when it comes to puns.) Practitioners, experts, businessmen and academics alike are coming together to identify the main challenges they are facing to building sustainable markets for sanitation products and services.

Why markets? Research conducted by many of the development organizations in attendance has found that in most areas where sanitation coverage is low, households want to buy a toilet, but cannot afford one that meets their needs. The solution lies in designing innovative business models, identifying entrepreneurs, creating affordable products and supporting sales and marketing to build up markets for sanitation. Organizations have done this for years with products like water filters, mosquito nets and condoms. Why should toilets be any different?

While there are increasing investments in sanitation, progress remains slow. This week’s gathering of over 170 participants began with Day 1: Understanding the Blockages. The days that follow are dedicated to a collaborative effort to determine the best approaches to remove them. By working with our partners to leverage each other’s strengths, the workshop participants can increase their relevance and address the global sanitation crisis efficiently and effectively.

You can follow the exciting developments from the workshop on here and on Twitter, simply search for the hashtag #unclogit. Join in the action by sending your questions and comments using #unclogit, and keep checking back here daily on the blog to see how we are unclogging the blockages!

Welcome!

It is a seminal time for sanitation professionals to explore how to achieve better and faster results of public and private sector sanitation service delivery. Part of this is learning what others are doing and what they see and understand are the major barriers to move forward. Part is also seeing how is it possible to work better together in innovative ways that integrates community and market approaches and that branch across sectors and organizations.  This brings us to the gathering of minds known as Unclogging the Blockages in Sanitation, February 18-20, 2014 in Kampala, Uganda.

Check back here for regular updates!