Part II of two. We pick up the narrative as villagers choose a latrine design and set forth a hopeful future.
SPRINGFIELD – The community market latrine in the town of Nano was a significant milepost for the project – past, present, and future.
From the time the first latrines were being installed in Nano, the Health Committee, the village Chief, and Village Council had wanted a certain public latrine fixed. The latrine was a public toilet for the village market and had been constructed as part of a Peace Corps project.
The problem was the “problem of the commons.”
It was for everybody – but nobody was responsible for it.
It had six stalls on one side for men, and six stalls on the opposite side for women. Very quickly the pits beneath the squat hole in the concrete floor of each stall had become full to overflowing, with no one to clean them out. Nor would it be easy to clean out the pits through the small squat hole.
It was known locally as The Disaster. When we first were shown “the disaster” it had been that way for nearly a decade. The village wanted us to tear it down and build a new one. We said no, but encouraged them to devise a plan for how it was to be financed, maintained, and the waste safely removed longterm. After years. of discussion, they came up with a design and a plan.
The design was a flush channel latrine. It looks like any other multi-stall latrine, but instead of a pit beneath each stall it is simply a channel beneath each stall that is periodically flushed with water, which washes the waste down into a large septic tank for digestion.
The large septic tank would periodically be pumped and the waste taken to a safe disposal area. The city of Dapaong had a septic sludge-pumping truck and could pump the waste. The Health Committee would operate the latrine and maintain it. They would charge vendors at the market a fee to help maintain it and charge users pennies for its use.
The latrine would help keep people from simply leaving their waste in alleys, fields, and other locations around the market area. It is a 12-stall (six for men, six for women) community latrine with two showers, a water capture tank (roof water) for running the system, and a very large septic tank.
As the market latrine was finished and put into operation everything was going along fine – until Dapaong city leaders informed the Nano Health Committee that their truck was so booked up they could not come to Nano to pump the septic tank.
Now what?
At first, the Health Committee wanted help purchasing a sludge-pumping truck like the one in Dapaong. Our response: that starts at about $350,000 U.S. and is expensive to fix and to operate.
We asked, “What can you do with a budget of $30,000 U.S. or so?” We had already done research on alternatives we thought might work, but it was not our decision, so we kept quiet and let them figure out what would work for them. They came back with the idea of using 3-wheel motorcycles (that they know how to maintain and fix), pull tanks, and portable gasoline engine trash pumps designed specifically to pump sludge.
They could outfit three of these to do small jobs in various places or to bring all three together at one location for large jobs like the market latrine. Further, they could charge for this service, which was a growing need in the region.
They would be able to pump latrine pits throughout the area (lessening the need to abandon and build new latrines), and generate income to support employees and fund projects. Before the equipment was even purchased the “business” had 16 orders for septic-tank pumping.
The Nano Health Committee became the owner and operator of the three sludge-pumping units. The grant was an economic development grant to establish a nonprofit sludge-pumping business that would produce revenue for the Health Committee, provide jobs for the operators, and provide a service to the community.
But now the question became how would the Health Committee safely dispose of all the waste they collected? The waste, of course, contains microbes of every disease in the village and surrounding area where pumping was to occur.
A brilliant solution
The village government of Nano, the Chief, and Village Council dedicated 400 hectares to the Nano Health Committee as a safe disposal area for the waste. The Health Committee then used some of the money from the purchase of the sludge-pumping units to purchase farming tools.
The sludge goes into the dedicated farm; access is restricted because of the waste. The waste is used as a fertilizer, and the crops that are grown are sold and the money added to the Nano Health Committee account for public health-related uses that the committee finds most important.
The farm is so successful the committee is looking to install more market latrines to collect more sludge for fertilizer. As a side note, the soil in the northern region of Togo, including Nano, is derived from billion-year-old rocks and has had all that time to have the nutrients leached out of it. Fertilizer is a difference-maker.
Taking care of human waste can provide so much more than just eliminating a smelly problem.
To the rescue
The Health Committee, village government, and the village residents had asked for “the disaster” market latrine to be fixed for years – and they had a second request for almost as long.
They sought an ambulance to transport people to the hospital in Dapaong, 25 kilometers from Nano. Though there are health clinics in Nano and surrounding rural communities, these are staffed by nurses and medical technicians, but not doctors. There are no in-patient services, no operating facilities, nor the ability to treat major diseases or traumas. They are akin to first-aid stations, with some chronic disease care.
They have no ability to move the patients to critical care facilities only 25 kilometers away when the health issues are more than the clinic can treat.
In spite of the obvious need, we had consistently declined their request since they had no way to maintain or continue operating such a vehicle and service. In fact, during one of our stays in Nano (Rotary members have been there six times for between 7-30 days each visit), a teenage girl died during childbirth simply because she could not be taken the 25 kilometers to Dapaong where the hospital would have performed a C-section and saved her and her baby. As it was, she suffered a long and painful death.
This happens often in Nano. Funerals occur about every other to every third day in a population of about 5,000. You know when a funeral is occurring, as the wailing lasts all night, as required in their culture.
So the Health Committee, with its ability to generate money from the sludge-pumping and sludge-disposal farm, now has the ability to provide an ambulance service. With their experience with the 3-wheel sludge-pumping units, they immediately chose 3-wheel ambulances that can serve the community.
Rotary has secured a Global Grant for four such units that will serve not only Nano but surrounding communities in the region (attached to the clinics in various villages). When the units are not needed for emergency transport, they will be used to deliver non-critical care in the community, and public-health education. That gives the Health Committee members an opening for a conversation about public health principles. Nurses from the clinics will staff the ambulances, and the Health Committee will provide drivers. The hospital in Dapaong has declared its readiness to accept the patients.
The impact continues to widen.
