NATIONALNATIONALSANITATIONSANITATION

POLICYPOLICY

NATIONAL SANITATIONTASK TEAM

REPUBLIC OF SOUTH AFRICA

OCTOBER1996

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FOREWORD

TO THE WHITE PAPER

This policy has been produced in recognition of the many people of our country, and inparticular the children, that have endured illness and hardship as a result of not havingaccess to basic information about sanitation or the use of adequate facilities.

The National Sanitation Task Team (NSTT) was established as a result of Government’scommitment to improving this situation. The NSTT is a collaborative effort of six governmentdepartments and its main tasks are the development of a national policy and acorresponding implementation strategy.

The policy is the result of a broad consultative process that started with a Sanitation ThinkTank in August 1995. This Think Tank determined the scope and content of the document.In November 1995 the six co-operating departments’ ministers held a joint press conferenceand released the Draft White Paper on Sanitation. This marked the beginning of a series ofprovincial workshops which discussed and debated the proposed policy. Some 600 peoplefrom a wide range of backgrounds actively participated. The comments, criticisms andsuggestions that were made were collated and have been integrated into this document.

Sanitation can encompass a wide range of activities, many of which require governmentpolicy guidance. In order to make an immediate contribution, this document concentrates onthe most pressing of issues, namely the safe disposal of human waste and domestic wastewater in conjunction with appropriate health and hygiene practices.

There are a number of related issues that require policy and direction, in particular themanagement and disposal of domestic and other solid waste. Recognising that there areconstraints on the rate of progress that can be made, this document is intended as one morestep on the long road of improving the quality of life of the people of our country.

National Sanitation Task Team August 1996

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PREFACE

This National Sanitation Policy paper addresses a subject thatintimately affects every one of us. It is not simply a matter ofproviding toilets.

To deal with sanitation requires the co-operation of a number ofagencies and government departments.

That is why we have taken the unusual step of coming togetherto issue this policy paper jointly.

Prof. Kader Asmal, MPMinister of Water Affairs and Forestry

Prof. Sibusiso Bengu, MPMinister of Education

Mr. Pallo Jordan , MPMinister of Environmental Affairs and Tourism

Dr. Nkosasana Dlamini-Zuma, MPMinister of Health

Mr. Mohammed Valli Moosa, MPMinister of Constitutional Development and Provincial Affairs

Mrs. Sankie Mthembi-Mahanyele, MPMinister of Housing

Republic of South Africa August 1996

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TABLE OF CONTENTS

FOREWORD II

EXECUTIVE SUMMARY v

SECTION A: INTRODUCTION 1

SECTION B: POLICY PRINCIPLES 4

SECTION C: NATIONAL SANITATION POLICY 6

1 Health and hygiene education and promotion 62 Community issues and human resources development 93 Environmental impact 124 Financial and economic approach 155 Technical considerations 196 Institutional and organisational framework 24

SECTION D: LOOKING AHEAD 28

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EXECUTIVE SUMMARY

his policy paper starts where theprevious White Paper on WaterSupply and Sanitation Policy ended.It talks about the same important

issues, that is the needs and wishes ofordinary people, particularly their desirefor healthy living conditions. It is alsoconcerned with those issues which canaffect the delivery of services, especiallythe economy and the environment.

Sanitation for households means muchmore than building toilets. The mostimportant requirement for safe sanitationis, of course, getting rid of human excreta,dirty water and household refuse. Alsocrucial are the way people think andbehave, and whether they have hygienicand healthy habits. Sanitationimprovement is a bigger process, aimed atthe individual, the home and thecommunity, which must include health andhygiene education as well as sustainableimproved toilet facilities, water supply andmethods of removal of dirty water andhousehold refuse.

Providing, improving and maintainingsatisfactory sanitation affects all membersof society. This policy must apply in allsituations: in rich and poor communities, inrural and urban areas, and whethersanitation is for individual households orprovided as a system for an entirecommunity.

As a policy document, the White Paperprovides a foundation on which we canbuild future sanitation improvementprogrammes. It is not an implementationmanual and only provides detailedinformation where this is necessary to helpreaders understand the reasoning behindthe policies. It contains sufficientinformation to be a complete policy, butaims to be flexible enough to allow localstructures to decide what approaches arebest for them, within the nationalframework.

SANITATION IS ABOUT HEALTH

The major aim of national policy oncommunity sanitation is to improve thehealth and quality of life of the wholepopulation. Improved sanitation facilitieswill reduce the incidence of disease, butonly if there is improved hygiene practiceand behaviour as well. Health departmentpersonnel at local level will play animportant part in the promotion andeducation activities that are essential forsuccess. The sanitation programmeshould check that health is really beingimproved and modify health educationapproaches if necessary.

COMMUNITIES MUST BE INVOLVED

A sanitation improvement programmeshould help people to help themselves.government programmes must involvecommunity members in local planning,organisation and implementation. Thewhole community should take part in someway, especially the women and children.With appropriate training, programmesshould support the development of localgovernment, especially in rural areas.

THE ENVIRONMENTAL IMPACT OFSANITATION

Sanitation systems should protect theenvironment and not harm it. Water is ascarce resource in South Africa, and itshould be protected and used carefully.There are many threats of pollution wherethere are no sanitation systems or wherethey do not work properly. The worst risksare to water supplies in rivers, dams andunderground. This in turn can causeserious health problems.

The proper operation of sanitationsystems is essential to protect theenvironment, and must be paid for. Acomplicated, expensive system which ispoorly maintained can be just as harmfulto the environment as having no system atall.

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HOW WILL SANITATIONIMPROVEMENTS BE PAID FOR?

One important question is: “Can we affordexpensive sanitation systems for everyoneright now?”. The capital and running costsof improved sanitation, and particularlywater-borne sewerage, are very high com-pared with what low income householdscan afford. To build, operate and maintainsewerage systems for all householdswould be very expensive indeed. Govern-ment (all levels) is asked to pay for manythings out of what it collects in taxes and itcannot afford the full cost of sanitationimprovements for everyone, andespecially the cost of operating andmaintaining expensive systems. As aresult we must consider approaches whichuse less government funds.

Because of this, government has setrealistic limits on the amount of grants andsubsidies that it will provide for services. Insummary, government may support localauthorities, for municipal services such assanitation, with the funds needed to buildthe basic minimum level of service.

For new housing in urban areas, this willmostly happen as part of the nationalhousing subsidy scheme which is used toprovide on-site and internal services. Forexisting urban households the sanitationsubsidy will be available through theMunicipal Infrastructure Programme orother funds. For rural householdssubsidies will be available though a similarprogramme and will be set according toclear rules.

For all existing households the subsidy willbe an incentive with which to improvesanitation and will not cover the full costs.Each household will be expected tocontribute something toward the provisionof their toilet.

The basic level of service referred to isone which will be adequate to protecteveryone’s health, since improved healthhelps people to work better and spendless on doctors and medicines. Wherelocal communities desire a moreconvenient (and more expensive) level of

service, they are free to choose thisprovided that they are willing to pay theextra costs of building and running thatsystem.

Government will not be increasing thegrants used to help some localgovernments pay for running services.This means that local authorities must aimto receive enough money to pay foroperations and maintenance, and forrepaying loans used to build the services.Most of this money should come fromservice charges and local taxes.

Government plans to introduce a standardmethod to calculate the level of tariffs forservices provided by local authorities. Thiswill help service providers to set tariffslocally and at the same time to meetgovernment’s social and economic goals.These goals include providing for theneeds of the poor and protecting theenvironment in a way which makes surethat the services receive enough money tooperate properly. It is well known thatmany low income households are enjoyinga level of service where the full cost isunaffordable to them. The new way ofsetting tariffs will encourage localauthorities to assist low income familiesthrough a low-cost “lifeline” tariff for thosewho use a small amount of the service.

WHICH SANITATION SYSTEM IS MOSTSUITABLE?

Both sewerage and bucket systems areexpensive and need well-runorganisations to make sure they are safefor users and the environment. Because ofthis, other sanitation systems have beenused in developing areas, and there isnow a range of systems that can be usedin different situations.

Choosing the most suitable sanitationsystem is not a simple decision to bemade only by engineers. There are anumber of important points to consider.These include:

• Is the proposed system affordable tothe user, the service supplier and thegovernment?

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• What kind of organisation will beneeded? How complicated must it be?

• What will be the risks to theenvironment?

• Is it acceptable to people (bearing inmind the cost to them)?

• What is the water supply like? Is itadequate? Can it support the proposedsanitation system?

• Will the system be reliable in thissituation?

• Can it be upgraded, when people canafford a more expensive system?

• How much of the system can be builtand maintained by local people usingmaterials locally available?

• Does the housing layout make somesystems more difficult to build or run?

Improving household sanitation is notsomething which happens once in alifetime. It is a continuous process in whicha family should be able to obtain the typeof sanitation for which it is willing to pay.Technical advice and financial help shouldbe available to families wishing to improveor upgrade their sanitation facilities, wherethis is technically feasible.

WHO IS RESPONSIBLE?

The main responsibility for providinghousehold sanitation rests with the familyor household. The role of localgovernment is to help make this possible,or to carry out those functions which canbe done more efficiently at a communitylevel. Both provincial and nationalgovernment will support and assist localgovernment to fulfil this responsibility.

The National Sanitation Task Team(NSTT) will be establishing an urgentlyneeded national sanitation improvementprogramme. This will be led by theDepartment of Water Affairs and Forestryand the Department of Health. The goal ofsuch a programme is to help all SouthAfricans to obtain adequate sanitation.

WHAT NEXT?

The next steps for action after publicationof this paper include:

• developing strategies, plans andprojects for a sanitation improvementprogramme;

• making changes to the law andregulations where they are needed;and

• increasing capacity to implement anational sanitation improvement pro-gramme.

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SECTION A:INTRODUCTION

he White Paper on Water Supply and Sanitation Policy, published in November 1994,indicated that more work had to be done to clarify many items of sanitation policy, andthen to develop a national sanitation strategy. For the first time in this country, theWater Supply and Sanitation Policy addressed the needs of all South Africans, mindful

of the aspirations of the people, and of the growing constraints on resources - both economicand environmental.

This policy paper is the next step in thatprocess, and it addresses the same keyissues: the needs and aspirations ofordinary people. In particular it focuses onthe need for healthy living conditions, andthe constraints imposed on servicedelivery, especially by economic andenvironmental issues. These issues areclosely linked and require an integratedapproach, which this paper attempts toconvey.

The question of sanitation, perhaps morethan most development issues, needs tobe seen in the context of an integrateddevelopment strategy. Water supply andsanitation are unavoidably linked to thebroader development process: sanitationaffects, and is affected by, a wide range ofissues.

For this reason it is not possible to assignsanitation to a single governmentdepartment. A co-operative approach hastherefore been taken with this policypaper: six government departments haveworked in close collaboration in itsformulation, representing the many facetsof sanitation. They will continue to worktogether in planning, implementing andmonitoring future programmes. Centralgovernment will work closely withprovinces to assist local authorities wherenecessary to ensure that adequateservices are developed and that waterquality is not compromised throughinadequate or ineffective waste manage-ment.

There are many unknowns in the businessof improving sanitation for low incomehouseholds. This policy paper is thereforenot cast in concrete, and all developments

are to be structured in such a way thatmistakes are easily spotted and corrected,and changes to the policy are made ifnecessary.

The sanitation problem and itsimpact

An estimated 21 million South Africans donot have access to adequate sanitationfacilities1. Those who have inadequatesanitation may be using the bucketsystem, unimproved pit toilets or the veld.In addition there is a disturbing increase inpoorly designed or operated water-bornesewerage systems. When these fail, theimpact on the health of the community andothers downstream, and the pollution ofthe environment, are extremely serious.

The inadequate excreta2 disposal facilitiesmentioned above, combined withunhygienic practices, represent SouthAfrica’s sanitation problem. Often theunhygienic practices are related to:

• a lack of access to health and hygieneeducation;

• inadequate water supplies;• poor facilities for the safe disposal of water

and other domestic waste; and• inadequate toilet facilities.

The effects of the sanitation problem arethreefold:

• health impact - the impact of inadequatesanitation on the health of the poor issignificant in terms of the quality of life andthe education and development potential ofcommunities;

1 Standing Committee on Water and Sanitation(SCOWSAS)2 Excreta: solid and liquid wastes expelled from body

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• economic impact - poor health keeps

families in a cycle of poverty and lostincome. The national cost of lostproductivity, reduced educational potentialand curative health care is substantial; and

• environmental effects - inadequate

sanitation leads to dispersed pollution ofwater sources. This in turn increases thecost of downstream water treatment, aswell as the risk of disease for communitieswho use untreated water.

Purpose and scope of the document

Government seeks to fulfil its responsibilityto ensure that all South Africans haveaccess to adequate sanitation services.The publication of this White Paper is afirst step in this process.

The purpose of this White Paper is to:

• articulate government policies oncommunity3 sanitation, in order to providea basis for the formulation of sanitationimplementation strategies which will beappropriate to the wide range of situationsfound in South Africa;

• inform people on sanitation issues, to theextent that is necessary for them tounderstand the policies; and

• convey the outcome of the consultativeprocess that led to the final version of theWhite Paper.

This White Paper provides a frameworkfor the development of strategies toimprove community sanitation services.However, it is a policy document, and notan implementation manual. As such, theWhite Paper does not aim to tell peoplehow to go about improving sanitation.Specific implementation strategies shouldbe formulated at the provincial and locallevel rather than at national level.

The White Paper addresses sanitation inboth urban and rural areas. It focuses oncommunity sanitation, and does not referto waste and wastewater from industrialsources, as this is dealt with by the Water

3 The term communities in this document includeshouseholds, commercial premises, schools, clinics,churches and any other institution found in typicalcommunities.

Act and other policy documents andlegislation.

Structure of the document

Section B of the document explains theprinciples that underlie the policy. Themain body of the document is contained inSection C, which presents the nationalsanitation policy and is divided into sixsub-sections, each dealing with aparticular aspect of sanitation.

In order to clearly distinguish betweenpolicy and explanation, in Section C policystatements are presented in a shaded boxat the beginning of each sub-section.

It is important to note that these sub-sections have been chosen to make iteasier to describe the different aspects ofsanitation. However there are complexinter-relationships between each aspect,and no element can be dealt with inisolation4.

In the past, community sanitation hasbeen seen primarily as a technical issue,whilst other aspects have been givensecondary consideration. It is nowrecognised that other elements ofsanitation, particularly social issues andhealth and hygiene education, are ofcentral importance.

This document is intended to cover thewide range of circumstances found inSouth Africa, and so the bulk of the WhitePaper refers to the country as a whole.Sub-headings are used where discussionof specific circumstances is required, suchas rural, urban and peri-urban areas.

4 For example, the technology chosen for a project is notdependent on environmental factors only but also oneconomic ones. These in turn influence the organisationaland institutional arrangements required to maintain thechosen technology.

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Clarification of terms used in thiswhite paper

The following definitions of key terms havebeen adopted for the purposes of thisWhite Paper. They are not the last wordon the subject, and are the result ofcompromise.

What is meant by the term“sanitation”?

Sanitation can be defined in different waysdepending on the circumstances.However, it is generally acknowledgedthat it includes a range of elements suchas:

• physical infrastructure,• hygiene-related behaviour,• disposal of wastewater, excreta and other

solid wastes, in the context of householdand institutional activities.

Because these aspects are inter-relatedand of equal importance, the followingbroad definition has been adopted for thepurpose of this policy document:

The term SANITATION refers to theprinciples and practices relating to thecollection, removal or disposal ofhuman excreta, refuse and waste water,as they impact upon users, operatorsand the environment.

What is “adequate sanitation”?

Opinions vary widely on this. In thisdocument the following definition will beused which includes both physical facilitiesand practices:

The term ADEQUATE SANITATIONmeans the provision and ongoingoperation and maintenance of systemof disposing of human excreta5, wastewater and household refuse, which isacceptable and affordable to the users.

5The term system for disposing of human excreta refers totoilet facilities and the associated tanks, pipes, treatmentworks etc. which may be part of a private, public orcommunal arrangement.

The system must be structurally safe,hygienic and easily accessible. Eachhousehold should have access to itsown facilities. Furthermore it should beaccompanied by correct hygienicpractices and does not have anunacceptable impact on the environ-ment.

When the elements of adequate sanitationidentified in this definition are broughttogether, they provide an effective barrieragainst diseases related to excreta.

What is a “Basic Level Of Service”?

For the purposes of this policy document:

The term BASIC LEVEL OF SERVICEfor a household means a VentilatedImproved Pit (VIP) toilet in a variety offorms, or its equivalent, as long as itmeets minimum requirements in termsof cost, sturdiness, health benefits andenvironmental impact.

In addition provision should be madefor an ongoing programme of easy tounderstand information about correcthygiene practices.

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SECTION B:POLICY PRINCIPLES

he eight policy principles stated in the White Paper on Water Supply and SanitationPolicy of 1994 form our initial point of departure, with the addition of two more. Thepolicy principles apply in rich and poor communities, in rural and urban areas, andwhether sanitation is for individual households or provided as a system for an entire

community.

1. Development should be demand-driven and community based.

Household sanitation is first and foremosta household responsibility and is demand-driven6.

2. Basic services are a human right.

In fulfilment of its obligation, governmentmust create an enabling environmentthrough which all South Africans canaccess services and support in obtainingthose services, but in the end it isindividuals who are responsible.

3. “Some for All” rather than “All forSome”.

The use of scarce public funds must beconfined to assisting those who are unableto attain a basic level of service.

Individual householders are ultimatelyresponsible, although communities mayrequire a degree of conformity to achievethe “healthy environment” envisaged in theConstitution. A careful balance needs tobe achieved between what is affordable tohouseholds, communities and the nationaleconomy.

6 The term demand-driven means that communities andhouseholds show their priorities by a willingness to pay, incash or in kind, a significant portion of the costs involvedin providing and running a sanitation system.

4. Equitable regional allocation ofdevelopment resources.

The limited national resources available tosupport the provision of basic servicesshould be equitably distributed throughoutthe country, according to population andlevel of development.

5. Water has an economic value.

The way in which sanitation services areprovided must take into account thegrowing scarcity of good quality water inSouth Africa. The true value of theseservices must be reflected in such a waythat it does not undermine long termsustainability and economic growth. Thepollution of water resources also has aneconomic cost.

6. The user pays.

Sanitation systems must be sustainable.This means they must be affordable to theservice provider, and payment by the useris essential to ensure this. Similarly,polluters must pay for the cost of cleaningup the impact of their pollution on theenvironment.

7. Integrated development.

Sanitation development is not possible inisolation from other sectors. There is adirect relationship between water supplyand sanitation and their combined impacton health. Co-ordination is necessarybetween different departments, all tiers ofgovernment and other stakeholders.

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8. Environmental integrity.

The environment must be considered in alldevelopment activities. Appropriateprotection of the environment must beapplied, including if necessary prosecutionunder the law. Sanitation services whichhave unacceptable impacts on theenvironment cannot be considered to beadequate.

9. Sanitation is about health.

Sanitation is far more than theconstruction of toilets - it is a process ofimprovements which must beaccompanied by promotional activities aswell as health and hygiene education. Theaim is to encourage and assist people toimprove their health and quality of life.

10. Sanitation is a communityresponsibility.

Improvements in health through improvedsanitation are most likely to be achievedwhen the majority of households in acommunity are involved. Sanitation istherefore a community responsibility, andthis must be emphasised throughsanitation awareness programmes.

The next section of the NationalSanitation Policy is arranged in thefollowing order:

1. Health and hygiene education2. Community issues and human

resources development3. Environmental impact4. Financial and economic approach5. Technical considerations6. Institutional and organisational

frameworks.

These dimensions must be sufficientlydetailed to provide a comprehensive policybut flexible enough to allow for locallydetermined approaches. At the same time,they must ensure that adequate attention isgiven to the key objective of achievinglasting health benefits within the resourceconstraints of the economy and theenvironment.

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SECTION C:NATIONAL SANITATION POLICY

1 HEALTH AND HYGIENE EDUCATION AND PROMOTION

The aim of health and hygiene education and promotion policy is to:

• raise awareness of the diseases caused by unhealthy behaviour and practices;• support and provide health and hygiene education that will enable people to improve

their health through correct hygienic practices;• lead to an increased demand and willingness to pay for appropriate sanitation facilities.

Health and Hygiene education and promotion:1.1 must be an integral part of all community sanitation projects and community water

supply improvement projects;1.2 strategy will be drafted by various departments dealing in health, hygiene and

infrastructure provision. A task team for this purpose will be chaired and co-ordinatedby the Directorate of Environmental Health of the Department of Health, and operateunder the auspices of the National Sanitation Task Team;

1.3 will be community-driven and lead to the empowerment of communities;1.4 will be specifically targeted at high risk groups such at the mothers and carers of

infants and small children, and at the beneficiaries of new water supplies;1.5 strategy will be developed and based on operational research and a good

understanding of the wide range of health problems, different communities andcultures in South Africa;

1.6 will enhance the training of health workers in effective hygiene education methods;1.7 will be sensitive to specific local issues, such as rural and urban differences and

cultural factors;1.8 will be primarily implemented at the local level with support from provincial and

national structures; and1.9 programmes will be monitored and regularly evaluated for effectiveness.

Sanitation Is About Health

he major aim of national sanitationpolicy, and any consequentprogramme, is to contribute to

improving the health and quality of life ofthe whole population. At present,significant investments are being made inthe provision of safe water supplies for all.However, the health benefits that couldresult from this will be severely

limited if adequate attention is not paid tosanitation. Furthermore, experience fromnational and international water andsanitation programmes has shown howessential it is to link water supply andsanitation with health and hygieneeducation. Only when all these are inplace will real and lasting health benefitsfollow.

Because healthy and hygienic practicesare so important for achieving lastinghealth benefits, sanitation improvementprogrammes can never be confined to theprovision of toilets by governmentagencies. People must be convinced of

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the need for sanitation improvements; somuch so, that they will invest their ownresources into those improvements andadopt good hygiene practices.

Improved sanitation facilities will onlyachieve a parallel reduction in diarrhoealdiseases7 if they are developed alongsidehygiene programmes. Hygiene contributesto the prevention of the transmission ofexcreta-related diseases. It seeks topromote ways to create barriers betweenthe organisms that cause disease, theintermediate carrier and people.

Disease transmission paths

FingersWaste Flies& Food New HostExcreta Fluids (people)

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Health & Hygiene Related Issues

Hygiene messages: Hygiene information,education and awareness programmeswill be developed hand in hand withconstruction projects (water supplies,toilets etc), and will be targeted at alllevels:

• personal Hygiene: such as washinghands after going to the toilet or changingthe nappies of babies, and before thepreparation of food;

• household Hygiene: this includeskeeping the home and toilet clean,disposal of refuse and solid waste,cleanliness in areas where food is storedand prepared, and ensuring that food anddrinking water is kept covered anduncontaminated; and

• community Hygiene: pests carryingdiseases do not respect householdboundaries or fences. To achieveimproved public health the wholecommunity must be mobilised to worktogether for better health and a cleanerenvironment. Community hygiene willinclude issues related to excreta and

7 Diarrhoeal diseases are caused by organisms carried ininfected human excreta

sullage8 disposal, solid waste (refuse),hygiene education for food vendors, thekeeping of animals and communitystormwater drainage.

Raising awareness: Despite the stronglinks between sanitation and health, thereis little public awareness of this, andsanitation is commonly low on peoples'priorities for improved services. Thenational sanitation improvement pro-gramme will redress this throughinformation dissemination and educationto promote awareness of the role ofsanitation in health and to stimulate thewillingness to pay for toilet facilities andservices.

Health personnel will play a strong role inthe promotion of health and hygiene,particularly at the local level, where anetwork of Environmental Health Officersalready exists. Community sanitation willbecome a strong element of all primaryhealth care programmes and will belinked to new water supply infrastructure.It is essential that all clinic staff set thehighest standards for themselves inmaintaining hygienic sanitation facilities.For example, clinics should haveappropriate facilities for out-patients’ use,of a type that could be affordably copied ormodified for household use.

Dialogue: Hygiene promotion requires farmore than giving out information andbuilding demonstration toilets. The startingpoint is to understand current beliefs,perceptions and practices within aparticular community. Based on this,relevant messages can be developed sothat desirable behaviour change is broughtabout through dialogue, within the contextof people's everyday lives.

8 Sullage is dirty water from dish-washing, cooking orlaundry

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The education programme will proceedon many different levels: national andprovincial with strong media coverage andpublicity, and most importantly at a locallevel, through existing structures such asDevelopment Committees. The use ofparticipatory training materials will bepromoted and encouraged whereverappropriate. Traditional channels ofcommunication will be used wherepossible, particularly communal formssuch as drama and song.

It is important to ensure that theprogramme is very high profile andmaintains its momentum - achieving massbehaviour change is a very slow process,and immediate results cannot beexpected. It is anticipated that theprogramme will be phased over severalyears, depending on the initial capacityfound in any given area. Sanitation-relatededucational material should be developedfor use in pre-primary classes, non-formaleducation and for Adult Basic Educationand Training (ABET) programmes.

Urban and rural communities may needdifferent communication tools as thespecific health and hygiene problems andrisks found in rural and urban contexts willrequire different messages and advice tobe conveyed. For example, the issue ofhygiene and animals around water pointsmay be important in some ruralcommunities.

Links to other programmes: Theimprovement of water supplies in an areafrequently stimulates communities to lookat other improvements needed, such assanitation. The implementation of newwater supply systems should thus alwaysbe accompanied or even preceded by asanitation and hygiene educationprogramme. Such a programme shouldbecome an integral part of all communitywater supply projects.

Monitoring health impacts

To determine the success of the sanitationprogramme, progress will be monitored ona regional basis, and drawn together at anational level. The starting point formonitoring will be the “Basic SubsistenceFacilities” programme of theEnvironmental Health Directorate of theDepartment of Health. By recordingcertain information it is intended to makethe provision of sanitation a user-drivenprocess which is continually being refined.It will also be used to assist infrastructureplanning at local and provincial level.

Selective monitoring of hygienicpractices and incidences of diarrhoea andother hygiene-related infections such astrachoma, conjunctivitis and parasites willtake place. The education and informationprogramme will be monitored for continualimprovement. This will include 'child-friendliness' and the percentages ofwomen being involved in decision makingprocesses at all levels.9

Monitoring programme effectiveness:Communities participating in sanitationimprovement programmes will beencouraged to report serious diarrhoealincidences to clinics. These statistics canbe compiled at regional and provinciallevel, and ultimately at national level.

9 For instance, the Water Supply and Sanitation PolicyWhite Paper proposed that at least 30% of representativeson all forums should be women.

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2 COMMUNITY ISSUES AND HUMAN RESOURCESDEVELOPMENT

2.1 Communities must be involved in decision making about levels of service, according toon what they are willing to pay for both capital and recurrent costs. Such decisionsmust bemade in an informed and democratic manner.

2.2 Social and cultural factors will affect sanitation practices in some communities andmust be taken into account.

2.3 Community involvement in the pre-planning, planning, decision making andimplementation stages of sanitation projects is essential for increased commitment toand ownership of projects, which in turn are essential to achieveing sustainability ofprojects.

2.4 Women are to be involved in the decision making processes at all levels.2.5 Programmes should consider the full range of the communities sanitation needs( i.e.

not just households but also institution and public places)2.6 Improved sanitation will be marketed and promoted on the basis of social factors such

as increased privacy, status and convenience.2.7 Schools will be a major community focal point for sanitation promotion and health and

hygiene education.2.8 Water and sanitation will be included in the curricula of primary and secondary schools

as well as Adult Basic Education and Training (ABET), teacher and other professionaltraining courses.

2.9 Sanitation improvements should maximise the benefits to the local economy bymaking optimal use of local builders and businesses.

2.10 Environmental health technicians will be trained and deployed at the local level toassist with water and sanitation promotion programmes.

Sanitation is more than toilets

he policy principles in Section Bstress the point that sanitation is farmore than the construction of toilets,

it is a process of improvement. Toiletbuilding will be supported by promotionalactivities as well as health and hygieneeducation to encourage and assist peopleto improve their health and quality of life.

To undertake such a process ofimprovements within today’s economicconstraints and achieve lasting benefits tohealth and quality of life requires thecommitment not only of government but ofevery individual household. However, notevery household head is aware of thedamaging effects of poor sanitation on hisor her family and community. Because ofthis they are not yet prepared to committheir time, energy and money to sanitationimprovements.In fully developed areas, decisions on theinitial level of service have already beenmade. In developing areas however,

community members will have a stronginterest in choosing a level of service forwhich they are willing to pay, and inunderstanding the benefits of such andecision. Making an informed choice, andbeing committed to that choice, will onlyhappen when ordinary people havebecome involved and at last discover whatthey can do to help themselves and theirfamilies break out of the cycle of diseaseand poverty.

Social context of sanitation

Helping people to help themselvesrequires a knowledge of and sensitivity tothe social context of a sanitationimprovement programme. Governmentprogrammes must adopt people-orientedstrategies in which community membersplay an active role in planning andorganisation so that local values areincorporated. This will ensure that theresulting programme is:

• relevant

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• appropriate• acceptable• accessible• affordable• equitable• empowering, and• based on indigenous knowledge and

local skills.

Community involvement

As emphasised above, communityinvolvement is essential for long termsuccess. Urban local governments need todevelop the capacity to involve people inlocal decision making. In rural areasexisting bodies such as local DevelopmentCommittees or Water and SanitationCommittees, assisted by local governmentor water boards where possible, will beinvolved in promoting sanitationprogrammes.

A programme will not succeed unless thewhole community is mobilised, particu-larly women and children. Sanitationprogrammes should look to the specialrequirements of the disabled, elderly andyoung children.

It is the responsibility of each communityto safeguard public health, and to reachconsensus as to the sanitation system thatis affordable and acceptable. Theimprovements that can be made toexisting systems will be promoted as partof the education process, andconsideration should always be given tothe potential for upgrading any option.

Promotion and marketing methods willinclude forms of social marketing, forinstance highlighting privacy and status toenhance popularity. These have beenshown in other countries to be strongerselling points than the health benefits.Peer pressure can be an effectivemotivating force for ensuring increasedawareness.

At a local level, government and projectpersonnel must ensure that all relevanttechnical options are explained anddiscussed, enabling informed decisions tobe made. Where expectations may be

impossibly high, this will be an opportunityto explain the costs involved, and therange of other options available.

Community Sanitation Needs

Sanitation programmes should considerthe full range of sanitation needs withinthe community. This means including notonly households but also institutions (e.g.schools, churches, crèches etc) and therequirements of public places such as busstops, markets, courts, sports grounds etc.

Schools are a natural focal point forsanitation and hygiene education,encouraging the adoption of good hygienepractice from an early age. For this reasonit is important that theory and practicecoincide: all schools should have hygienic,attractive, appropriate toilets and hand-washing facilities, and the use of thesefacilities should be linked to lessons onpersonal hygiene and health.

South Africa will promote child-friendlytoilet facilities, with children's views ondesign being specifically sought and actedupon. This will start with school facilities,as they are often a rural child's firstexperience of toilets. All schools will becharged with ensuring that their toilets areeasy for children to use and are kept clean(e.g. by employing a caretaker speciallyfor this purpose).

Non-Governmental Organisations haveconsiderable experience in variousaspects of community-based sanitationand health improvement programmes. It isenvisaged that NGOs will continue to playan important role and government willactively will seek their support.

The Private Sector can be involved inmany aspects of sanitation such astraining, hygiene education and promotionand building of sanitation facilities,particularly where this results in localbusiness development and providesemployment. Government will seek toforge working partnerships with the privatesector to enhance local capacity andbusiness opportunities.

11

Human resources development

Sanitation improvement programmes willdepend largely on the quality and trainingof the people involved in implementation.This element cannot be sufficientlystressed. Training and/or retraining atevery level is needed.

Training and capacity building atcommunity level has already beenhighlighted as a universal need in SouthAfrica. There is however a severeshortage of suitable individuals toundertake this work. Government hascommitted itself to addressing thissituation.

Training curricula of health personnelwill be reviewed to develop the requiredskills for the promotion of sanitation andhygiene. Support will be provided on anational as well as a regional level, and

the programme monitored closely toensure good coverage. Teams ofEnvironmental Health Technicians will betrained and deployed to work at the locallevel under the supervision of theEnvironmental Health Officers.

Training of small-scale builders in theconstruction of appropriate sanitationfacilities will improve the quality ofproducts and ensure the ongoing nature ofprogrammes through private sectoractivity.

Retraining of professionals of manykinds - planners, engineers,administrators, communicators etc - willincrease sanitation capacity and improvethe status of a much neglected sector.

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3 ENVIRONMENTAL IMPACT

3.1 Sanitation improvement programmes must be undertaken in an environmentallysustainable manner.

3.2 The environmental impact of all sanitation systems will be monitored on an on-goingbasis.

3.3 Any activity that would result in the deterioration of the quality of a water resource mustbe carefully assessed.

3.4 Large scale on-site sanitation10 projects must be subject to environmental impactassessment.

3.5 Promotion of recycling and waste minimisation must form an integral part of wastemanagement strategies.

3.6 Environmental education must form an integral part of sanitation projects.3.7 The provision of adequate sanitation as a prerequisite for sound environmental

management will be recognised by legislation.

10 On-site sanitation is where reatment of excreta and wastewater takes place on the stand (site) of the household or institution.

his section of the White Paper is notintended to provide an answer toevery environmental issue facingSouth Africa and will cover only

issues that relate directly to theenvironmental sustainability of sanitationsystems.

In considering environmental issues it isimportant to note that most human activitychanges the environment. Adequatesanitation is an important way to minimiseor manage the negative impact of humansettlement on the environment.

Lack of adequate sanitation andinadequately maintained or inappropriatelydesigned systems constitute a range ofpollution risks to the environment,especially to surface and ground waterresources, which in turn pose a threat tohealth.

The environment should be addressed ina holistic manner and all naturalresources, of which water is mostimportant in the South African context, willbe carefully considered. Although watersystems are able to tolerate a certaindegree of pollution there is a limit to theamount that can be handled withoutcausing the water quality to deteriorate tosuch an extent that the water cannot beused.

Environmental sustainability

Environmental sustainability of sanitationsystems must be considered in terms ofboth provision and on-going maintenance.

The potential for a negative environmentalimpact of any system must be consideredduring the selection process. In otherwords a sanitation system must bedesigned and constructed in such a wayas to minimise potential pollutionthroughout its life cycle.

Every negative impact on the environmenthas a cost, even if it cannot be quantified.Where possible the cost must becalculated in order to evaluate alternativeapproaches to a problem by looking attotal system costs. Water resources areoften at risk of pollution from sanitationsystems, but before a decision is made toinvest heavily in changing the sanitationsystem, the extra costs of water treatmentand other environmental impacts will beestimated. This can then be comparedwith the costs of the options for sanitationimprovement, phased over time ifnecessary, to establish which is the bestcourse of action, both now and in thefuture.

T

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Monitoring environmental impacts

The potential for pollution of waterresources by sanitation systems requiresthat water quality monitoring programmesbe instituted as an integral part ofsanitation projects. Programmes need tobe developed which take into account thespecific conditions prevailing in an area.For example, in some rural areasgroundwater might be the only source ofdrinking water. If an on-site sanitationsystem is used, pollution couldconcentrate in the area where the water isbeing pumped out. Faecal contaminationshould be monitored in such a situation.

Likewise, in an urban area where anexisting water-borne system has failed(due to inadequate management,financing, design or construction) theenvironmental consequences could ex-ceed those of any other system.Parameters should be monitored thatwould predict such failure.

Monitoring programmes need to bedesigned within the context of theprevailing regulatory framework. Forexample, effluent11 from wastewatertreatment plants is subject to specificmonitoring requirements in order todetermine compliance with relevantstatutory standards.

Water quality management

The Department of Water Affairs andForestry has developed a comprehensivewater quality management policy whichmakes provision for the water qualityobjectives of any water resource to bedetermined by the users and DWAF. Inevaluating the most appropriate type ofsanitation systems for a particularsituation, the relevant water qualityobjectives for local water resources mustbe taken into account.

The Department of Water Affairs andForestry has released a number ofpublications to assist in evaluating the

11 Effluent is the contaminated liquid flowing out of asanitation system.

potential impact of sanitation systems onthe water environment. These include:

• A Guideline for Ground Water Protectionfor the Community Water Supply andSanitation Programme;

• Water Quality Management Policies andStrategies in the RSA;

• Procedures to Assess Effluent DischargeImpacts; and

• Minimum Requirements for WasteDisposal by Landfill.

The Department of Health, WaterResearch Commission (WRC) andCouncil for Scientific and IndustrialResearch (CSIR) have also undertakenresearch and published relevantguidelines concerning water quality.

Integrated EnvironmentalManagement

The design of sanitation improvementprojects will ensure that the environmentalconsequences are adequately consideredduring the planning process. The risk ofpollution through different sanitationapproaches will be assessed in order touse the option which will minimise impactson the environment in the most costeffective way. The IntegratedEnvironmental Management (IEM12)Guidelines have been prepared on whatlevel of impact assessment to use fordifferent types of projects.

Where it is envisaged that a significantenvironmental change may result, publicawareness and participation is essential.Information must be presented in an even-handed manner in order to convey thepotential costs and trade-offs. For ex-ample, comparision of the costs ofavoiding pollution with those of treating thepollution after it has happened should beaccompanied by an explanation of thereceiving water13 quality objectives.

Environmental Impact Assessment (EIA)procedures should be followed during the

12 Integrated Environmental Management is a series ofguidelines prepared by the Dept of Environmental Affairsand Tourism.13 Receiving waters are rivers or dams into which effluentis discharged.

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design and siting of waste water treatmentworks and waste disposal sites. As thedegree of complexity may vary accordingto the anticipated risk, appropriate riskassess-ment procedures need to bedeveloped.

Waste recycling and beneficiation

A holistic approach should be followedregarding the management of wastes fromsanitation systems. Where economicallyviable and sustainable, both the liquid andsolid constituents of the sewage disposalend products should be recycled forfurther use and for environmentalbeneficiation. The return of treated effluentto the water cycle is considered to beessential and deviations from thisapproach require special motivation.

Environmental education

Sound environmental principles and anenvironmental ethic should be createdamongst all South African communities.To this end, emphasis must be placed onformal as well as informal environmentaleducation activities. This education mustform part of the information transfer that isto accompany or even precede allsanitation projects. In addition, serviceproviders must encourage communities tobecome involved in monitoring the qualityof their own water resources, in order toheighten awareness of pollution. This inturn will lead to the identifying andpressurising of those responsible for it.

Economic instruments

The principal of ”the polluter pays” mustbe upheld, and full economic user chargesystems should be developed to ensurefull recognition of the costs ofenvironmental protection.

This should be tied in with presentdeliberations on the treatment of water asan economic good which should be valuedaccording to its scarcity and quality. Thusany reduction of receiving water qualityshould have a value assigned to it and thesource of pollution charged accordingly.

Environmental legislation

The Integrated Pollution Control (IPC)programme of the Department ofEnvironmental Affairs and Tourism willreview existing environmental legislation,government structures and functions, inorder to produce a more effective pollutioncontrol system. There will be changes tothe Water Act which will affect issues suchas groundwater quality, the recycling ofsewage sludge and the marine disposal ofeffluent.

The provision of adequate sanitation as aprerequisite for sound environmentalmanagement must be recognised bylegislation.

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4 FINANCIAL AND ECONOMIC APPROACH

General financing policy4.1 Grants for capital costs will be available where local authorities are unable to meet the

national basic level of service for sanitation.4.2 Where households and/or communities wish to have access to services which are more

expensive than the basic level, the extra capital and running costs must be met within thatlocal authority area.

4.3 Subsidies will be available to those who have agreed to contribute their own resources tosanitation improvement.

4.4 The amount of subsidy will be set according to a clear framework.4.5 Mechanisms will be developed to avoid double subsidies.4.6 Government would consider making capital grants to assist with alleviating a severe

environmental problem, provided this was not the result of mismanagement or injudiciousinvestments by the service provider.

4.7 Special attention will be given to ways of facilitating the improvement of sanitation forresidents on land owned by others, for example farm workers, refugees and people intransit.

4.8 Government will provide a subsidy to schools on a formula to be developed by theDepartment of Education. Budgets for new schools will provide for appropriate andadequate sanitation facilities.

Financing urban sanitationIn addition to the above principles in General Financing Policy these additional points apply:4.9 Capital expenditure should be financed by borrowing by service providers and some

grant finance.4.10 Recurrent expenditure (operations, maintenance, replacements, administration, loan

repayments) should be financed by current income, comprising consumer charges, localtaxes and inter-governmental transfers where they are available (see Tariff Policy below).

4.11 Sanitation for new housing will normally be funded through the national housing subsidyscheme. No separate subsidy for sanitation will be provided for households wheresanitation is covered by the housing subsidy.

4.12 For existing communities sanitation grants will be available through the MunicipalInfrastructure Programme or other sources.

4.13 Grants at national and provincial level for bulk and connector infrastructure14 and forrehabilitation and upgrading of sewerage systems will only be available under exceptionalcircumstances.

Financing rural sanitationIn addition to the above principles in General Financing Policy these additional points apply:4.14 Subsidies would be available for projects where communities have organised

themselves, possibly with the support of district authorities or private sector bodies, andhave planned a sanitation project.

4.15 In addition to capital grants government is prepared to assist district authorities cover thecost of district “sanitation teams” in the early part of a national sanitation improvementprogramme.

14 For example, treatment works, reservoirs and pipes serving large areas

16

Tariff policy4.16 Affordability: The setting of tariffs should take household affordability into account.4.17 Fairness: Tariff policies should be fair and simple to understand.4.18 Separate tariff: A separate tariff should be calculated for sanitation services, and will

vary according to the level of service provided.4.19 Payment in proportion to the amount consumed: For water-borne sanitation, the

tariff should reflect the actual quantity as well as load quality of wastewater dischargedto the sewer.

4.20 Financial viability of the local service agencies: It is essential that service agenciesremain financially viable, since failure to ensure this will result in breakdown of theservices.

4.21 Sustainability: Tariff structures that are reliant on unsustainable subsidies will meanthat essential maintenance of infrastructure is not carried out, and that there will beinadequate services in the future.

4.22 Payment of operation and maintenance costs: All households should pay at leastthe full operation and maintenance costs of the services consumed.

4.23 Lifeline tariff: Provision will be made for a "lifeline" tariff for poorer people who use littleof the service, but it should at least cover operating and maintenance costs. Tariffs shouldbe progressively more expensive for large consumers.

4.24 Transparent subsidies: Any subsidies which exist, including cross-subsidies betweendifferent categories of consumers, must be transparent15.

4.25 Efficient allocation and usage of resources: Tariff structures should facilitate theefficient usage and allocation of scarce resources - both renewable and non-renewable.

4.26 Economic development: Tariffs applied to mining, industrial and commercialenterprises should take into account their impact on economic development.

4.27 Local determination of tariff levels: Tariff levels should be decided at local authoritylevel within an agreed structure.

4.28 Consistent tariff enforcement: A consistent policy should be implemented wherebyfailure to pay (correctly) billed amounts for services results in the consumer’s servicebeing restricted or suspended.

15 transparent: visible, quantified, and understood by all those affected

nvestments in infrastructure, includingsanitation infrastructure, can delivermajor benefits in terms of improvedhealth, economic growth, enhancement

of quality of life, poverty alleviation, andenvironmental sustainability - provided thatthe services are in response to genuinedemand and that delivery is effective andefficient.

Sanitation improvements compete forresources in a variety of ways. Capitalinvestment is needed for different types ofinfrastructure, government funds areneeded for a wide range of services, andconsumer payments are subject to manydifferent demands. Trade-offs clearly existbetween the various programmes of

government and within the spending atternsof consumers.

Financial trade-offs are particularly critical inchoice of levels of service. For example, thecosts of a system must be measuredagainst the health benefits: from a publichealth point of view there is no differencebetween a well-built, properly maintainedVIP toilet and water-borne sewerage, butfinancially they are very different.

The economic and health benefits ofinstalling a more expensive system such aswater-borne sewerage may be minor, andthe only added benefit may be increasedconvenience and status. There is a real riskof incurring economic losses where lowincome households cannot afford therunning costs of an expensive system and

I

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extensive subsidies are then needed.Furthermore, where operational costs arenot met for lack of consumer payments orongoing subsidies, environmental problemsand clean-up costs may follow.

Affordability

Recent estimates of infrastructure needs inSouth Africa have shown that very largecapital investments would be needed toconstruct full water-borne seweragesystems for all unserved households. Evenif the capital funds were available, therewould still be a severe problem, as largenumbers of households would be unable toafford the regular running costs of such asystem. They would need an on-goingsubsidy on their use of the sewerageservice. This raises the issue of affordabilityat other levels, that of each local authorityarea and of the national economy.

While there is an urgent imperative tocorrect the wrongs of apartheid and toredress the past unequal distribution ofservices, the speed at which this can bedone must be in keeping with the capacityof local, regional and national economies tosupport it.

The enormous costs involved have forcedgovernment to formulate ways of stretchingits limited resources as far as possible. Thechoice of level of service and of technologymust be within the affordability constraintsof households, local authorities and centralgovernment, and government must setshort-term achievable goals in keeping withlonger term objectives.

Capital expenditure programmes shouldinclude detailed long term affordabilitystudies in order to establish the mostappropriate programmes and projectsfor continued financial viability.

Communities have the responsibility tochoose and implement the mix ofservice levels that they desire, takinginto account government policies andsocio-economic realities.Prioritised investments andtargeted subsidies

The Municipal Infrastructure InvestmentFramework, recently accepted by Cabinet,indicated that government cannotimmediately embark on a programme toprovide full services to all, but must deviseways of prioritising investments andtargeting subsidies (e.g. to support only abasic level of service for all). Hence thederivation of certain policy principles suchas “demand driven” and “the user pays”.

These are essentially economic instrumentsto enable households to set priorities forthemselves, based on their capacity andwillingness to pay for a particular levelof service, and so inform the planners whoserve them.

The Government of National Unity has,through its endorsement of the MunicipalInfrastructure Investment Framework,established a clear framework to governthe way in which municipal infrastructureshould be financed.

In essence, government financial supportto local authorities for infrastructure andservices will be limited to the amount ofcapital needed to achieve a basicminimum level of service. This will mostlybe effected through the on-site infra-structure component of the nationalhousing subsidy scheme, but may besupplemented with a grant toward bulkand connector services in cases wherelocal authorities are unable to raise thecapital required.

It is government’s standpoint that itsresponsibility is limited to providingcitizens with a level of service sufficient tosafeguard and promote public health, withits attendant economic benefits. Beyondthat, improvements should be subject toconsumer choice and full cost recovery.

Where local communities aspire to andare willing to pay the extra costs of a moreconvenient (and hence more expensive)level of service, they are free to raise theextra finance out of own sources or fromthe capital market, provided all the extrarunning costs are met from within thatcommunity.

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Government will not increase the amountsof inter-governmental transfers currentlyused to subsidise running cost shortfalls insome parts of the country. It is theprerogative of provinces to decide on thedistribution of these transfers, but the totalamount available will not be increased,and may well decrease rapidly over thenext few years. The implication for localauthorities is that all costs of a recurrentnature for municipal services, such asoperations, maintenance and loanrepayments, must be met from usercharges and local taxes. This must bedone without further recourse togovernmnet running cost subsidies.

Many low income households arepresently enjoying a level of servicewhose true cost, at average consumptionlevels, is beyond their ability to pay. Insuch cases government proposes toreformulate the tariff structures formunicipal services to encourage localauthorities to assist low income familiesthrough a low-cost “lifeline” tariff formodest levels of consumption. The detailsof such tariffs are still under preparation.

Service providers must plan to achievefull coverage as soon as practicable, atleast to a basic level of service. Theextension or upgrading of a serviceshould not result in a request to centralgovernment for a larger recurrent costsubsidy.

Financing urban sanitation

In urban areas, sanitation services are theresponsibility of local authorities. Theseservices must be provided (financed andbuilt), operated and maintained in a mannerwhich is financially viable throughout the lifeof that service. This means that theauthority (or a service provider on its behalf)needs to raise sufficient income to cover allexpenditure.

Financing rural sanitation

The provision of sanitation services in ruralareas is the responsibility of the localauthority. Finance could be sourcedthrough:

• consumer contributions;• central and provincial government line

departments;• sector utilities;• settlement grants administered by the

Department of Land Affairs;• limited local government borrowing; and• RSC/JSB16 levies.

In the absence of a housing or generalservices subsidy for new or existinghouseholds, a capital subsidy will beintroduced to enable individualhouseholders to improve their domesticsanitation to a basic level of service. This will be an interim arrangement untilsanitation can be integrated into futuresupport programmes for rural households.

Other costs associated with a sanitationimprovement programme (promotion,training, health education, administration),may be of a similar value to the directcapital subsidy. These may be regarded asan indirect subsidy from government.

Tariff policy

Government proposes to introduce a tariffstructure framework which will enableservice providers to set tariffs locally whilst,meeting government’s socio-economicobjectives. These objectives include theongoing financial viability of services,providing for the needs of the poor andconserving the environment. Actual tarifflevels could vary with local circumstances,but should comply with the policy principles.

Sanitation service providers areresponsible for implementation of anational sanitation tariff structure, basedon the national tariff policy.

16 Regional Services Councils/Joint Services Boards

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5 TECHNICAL CONSIDERATIONS

Health Aspects5.1 The sanitation systems must be designed and constructed provide an effective barrier

against disease transmission. Social and Educational Aspects5.2 The sanitation systems must be acceptable to the users.5.3 User education must be an integral part of sanitation projects.5.4 The special needs of children, disabled people and the elderly should be considered in

the design of facilities. Environmental Impact Aspects5.5 Sanitation systems should be designed to reduce the environmental impact of

unmanaged human waste disposal.5.6 The specific risks of system failure must be considered at the time of technology

selection.5.7 For all proposed extensive on-site sanitation programmes geo-hydrological tests must

be carried out to establish potential environmental impacts.5.8 The final disposal of effluent and sludge for both on-site and off-site systems must be

considered at the time of technology selection. Affordability5.9 Users should be given choices of technology wherever possible, each with different

costs.5.10 Potential users must be supplied with full information on both capital and operation

costs for the range of options in order to make an informed economic choice.5.11 Government will not be able to provide subsidies for the operation and maintenance

costs of sanitation systems. Such costs must be affordable at the local level. Upgrading5.12 For the household and community situation the potential for upgrading as affordability

increases should be considered when selection the technology. Institutional Needs5.13 Any sanitation improvement programme should include resources to develop the

necessary local institutional capacity to manage the ongoing programme and futureoperational needs.

Water Saving5.14 Where water-borne sanitation is to be installed the use of low flush technology and

appropriate reticulation systems will be actively encouraged.5.15 In areas where water supplies are limited or unreliable, water-dependent systems will

be discouraged.5.16 Innovative technologies must be subjected to independent evaluation and testing prior

to implementation. Other facilities5.17 Emphasis will be put on encouraging the construction of handwashing, domestic

sullage disposal and laundry facilities.

wide variety of sanitation systems iscurrently in use in South Africa,some more commonly than others,

and with varying degrees of success. Theyimpact differently on the environment andA

20

have widely differing costs and degrees ofacceptability to the users.

Technology Types

The main types of sanitation systemsinclude:

• traditional unimproved pits;• bucket toilets;• portable chemical toilets;• ventilated improved pit toilets;• low flow on-site sanitation (LOFLOS);• septic tanks and soakaways;• septic tank effluent drainage (solids-free

sewerage) systems; and• full water-borne sewerage.

Several of these technologies do not meetthis policy’s criteria for adequatesanitation:

• traditional unimproved pits, except inrare cases, do not provide a barrieragainst flies, besides their other defectswhich are usually related to quality ofconstruction;

• the bucket system, as commonly

operated in South Africa, does not provideadequate sanitation, as well as beingsocially unacceptable to most people;

Buckets are to be phased out and

replaced by an appropriate andadequate system.

• Portable chemical toilets are not

encouraged, except in emergencysituations, and then only for short periods,due to the high running costs involvedwhich frequently leads to over-utilisation;

The remainder of the options mentionedabove can all provide an adequate level ofsanitation, if they are properly designed,built and maintained. They comprise ahierarchy of options available to users(some of which are upgradable),depending on their economic means.There are a wide range of proprietarysystems (none of which are mentioned)available that can under certaincircumstances offer adequate sanitationoptions.

The “Basic level of service” is the firststage - the vital one of meeting basicfunctional, health and environmentalrequirements - in a process of gradualimprovement of the health and standard ofliving of all South Africans.

Hierarchy of Adequate SanitationTechnologies

System Degree of complexity Approxwater(l/flush)

VIP Simple, but needsproper design andconstruction; periodicdesludging or relocation

Nil

LOFLOS Some types usemechanical flushing;soakaway or soakpitneeds proper design;periodic desludging

0,5 to 1

Septic tank Soakaway needs properdesign andconstruction; periodicdesludging

6 to 15

Solids-freesewerage

Needs reticulation andtreatment works;periodic desludging

3 to 15

ConventionalSewerage

Needs reticulation andtreatment works

6 to 15

The hierarchy of adequate sanitationoptions can be viewed in different ways.From the point of view of the user, it isgenerally associated with progressivlyhigher costs (initial and ongoing), greateruse of water for flushing and improvedconvenience and status. For theorganisation responsible for managing thesystem, it is associated with both highercosts to be recovered from users, andincreasing operations and maintenancecomplexity (see table above).

Factors influencing technologychoice

Until very recently, the choice of sanitationtechnology has been regarded as theexclusive preserve of engineers who,naturally enough, concentrated purely ontechnical issues. However, in reality thereare numerous factors that must beconsidered, in a transparent manner andin close contact with prospectiveconsumers, when deciding on the mostappropriate technology for a particularsituation. The following list is not

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exhaustive but should address most of theissues.

Affordability: By far the most importantfactor influencing the choice of technologyis affordability - at household, local andnational levels. This is dealt with at lengthin the section on the Financial andEconomic Approach.

As far as it affects technology choice, itmust be clear who is willing to pay whatamounts for a particular level of service orquality of product. This is especiallyimportant when it comes to the need forregular payments for operations andmaintenance. Various grants or subsidiesmay reduce the initial cost to a household,but there will not be any subsidy availableto reduce the running costs.

Institutional needs: The more complexsystems may require substantialcommunity-level organisation andinstitutional support both for delivery andfor operation and maintenance. Anysanitation improvement scheme shouldinclude resources to develop thenecessary local institutional capacity tomanage the ongoing programme andfuture operational needs. In somecircumstances there may be considerablemerit in engaging the private sector tocarry out certain functions on behalf of alocal authority. Government will encouragelocal authorities to consider the variousoptions in this regard, using the guidelinespresently under preparation.

Environmental impact: All sanitationsystems should be designed to reduce theenvironmental impact of unmanagedhuman waste disposal. Nevertheless,most systems will cause some degree ofenvironmental impact, particularly if theyare not managed as well as the designerintended. The general risk ofenvironmental problems and the specificrisks resulting from system failure (and thelikelihood of failure) must be considered atthe time of technology selection (seeSection 3 on Environmental Impact).

Social issues: Social and culturalpractices and preferences vary

considerably from area to area. These willaffect the range of options acceptable toconsumers, and must be catered for, sothat facilities are used effectively andhealth benefits are gained by users andthe community as a whole.

Water supply service levels: Water is ascarce and costly resource in most partsof South Africa. Higher water supplyservice levels imply not only increasedwater usage and cost, but also the needfor a sanitation system which must takecare of waste water. This means someform of soakaway or even a piped system.Conversely, in areas where water suppliesare limited or unreliable, water-dependentsanitation systems should be discouraged.

As the cost of water supply increases, itbecomes increasingly uneconomic totreat, pump and store large quantities ofwater simply to flush down the toilet. Inkeeping with the National WaterConservation Campaign and internationaltrends, government will promote thedevelopment and widespread use ofwater-saving toilets.

Reliability: It is extremely important thatthose households with least to spend onsanitation are not supplied with unreliabletechnology. Only proven designs shouldbe used in large programmes. Inparticular, innovative and proprietarysystems must be tested againstperformance criteria and independentlyevaluated in terms of operationalrequirements, value-for-money andcustomer acceptability and satisfaction.This must be done before they becomepart of an extensive programme. To thisend, government will identify appropriatelyqualified and objective bodies to carry outsuch evaluations against agreed criteria.

Upgrading: As sanitation improvement isa process, it is desirable to considerhousehold upgrading (e.g. VIP to septictank) sequences, where this is likely in theforeseeable future. Designs should bedone accordingly, within today’s costconstraints. In some cases community up-grading (e.g. installing a sewer) should beconsidered at the planning stage.

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Site-specific issues: The geology,hydrology and topography of an area mayinfluence the choice of technology, insofaras they may affect ease of excavation,percolation rates and sewer gradients,amongst other factors. Geo-hydrologicaltesting must be undertaken beforeextensive high density on-site sanitationsystems are selected.

In a few cases site conditions may makethe use of low-cost on-site technologyquestionable, but frequently the cost ofinstalling and operating safe water-bornesystems is prohibitive. These situationswill require independent review andadvice, and a wider range of technologiesshould be considered.

Use of local resources: The localavailability of materials and skills has animportant bearing on the choice oftechnology or construction method. Thedesign of facilities should maximise theuse of these resources, in order tostimulate local economic activity andcreate jobs in keeping with the aims of theReconstruction and DevelopmentProgramme (RDP). The use of pre-fabricated factory-made componentsgenerally works against this principle,although in rare cases these could still beuseful.

Settlement patterns: The density andlayout of a settlement are importantfactors in selecting technology. Seweredsystems become more cost effective indenser areas, with more linear layouts,while on-site systems are generally moreviable where plots are larger.

Issues affecting technology choicein urban areas

The above points apply to all areas but inurban areas the following additional pointsmay have to be considered:

• Existing sewerage infrastructure, highdensity of housing and full waterreticulation systems may in some cases,alter the economic ranking of the variousoptions;

• With better water supplies and thepossible existence of trunk sewers 17, thecall for higher levels of sanitation is oftenheard. While the construction costs maybe met , it must always be asked whetherthe community is able and willing to paythe on-going operation and maintenancecosts of such systems;

In some urban situations people already

have sanitation infrastructure that theycannot afford to run and maintain. In thesecases the local authorities will need toconsider cross-subsidisation or othermeans of funding on-going costs; and

• The costs of emptying pits and tanks and

disposing of the contents must be includedin affordability calculations, alongside thecosts of conventional sewage disposal.

Issues affecting technology choicein rural areas

In rural areas the following points alsoneed consideration:

• due to the low density of housing in mostrural areas, conventional water dependentsewerage will usually not be feasible,mainly for economic reasons. Individualhouseholds wishing to have water systemswill normally be able to construct septictanks and soakaways themselves; and

• The specific needs of farmworkers on

private farms will need to be addressedwith modified strategies.

Hand-washing, sullage disposal andlaundry facilities

As previously mentioned, the full healthbenefits of improving sanitation facilitieswill only be realised through accom-panying behavioural change, in particularthrough the regular washing of hands afterusing the toilet. In those areas withoutindividual plot connections to a watersupply, government will actively promoteappropriate handwashing facilities to beincluded with toilet structures.

One disadvantage of many on-sitesystems of sanitation, including all types of 17 trunk sewers are the main sewer pipes used to conveysewage to the treatment works.

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pit toilets and LOFLOS, is their inability tohandle large quantities of water (except incases where soil percolation rates arehigh). This may mean that sullage or “greywater” generated by the family has to bedisposed of separately through a sullagesoakaway. Government will encourage theincreased use of sullage soakaways whichshould be designed on the same basis asthat for septic tank systems.

Areas without house connections for watersupply and sewerage commonly lacksuitable places for householders to washtheir laundry. This frequently leads tounsanitary conditions around sources ofwater. Government will encourage theinclusion of simple, purpose-made laundryfacilities near to water supply points aspart of a sanitation improvementprogramme.

Sanitation improvement is aprocess

Improvement of household sanitation is aprocess which keeps pace with ahousehold’s aspirations and willingness topay to fulfil those aspirations. LocalAuthorities or their agents should providehouseholds with the technical, financialand other support needed to upgrade theirsanitation facilities through a series ofinvestments.

Technical support for sanitationprovision and improvements

A vital element of the national sanitationimprovement programme will be ensuringthat sound sanitation systems areimplemented. Considerable good workhas already been done to prepareappropriate guidelines, with support fromthe Water Research Commission (WRC),

Council for Scientific and IndustrialResearch (CSIR) and the Department ofHousing. These guidelines include:

• “Preliminary guidelines for private sectorparticipation in water supply and sanitationservices (WRC)

• “Planning and implementation of water

and sanitation projects - Guidelines fordevelopers and local authorities” (WRC)

• “Guidelines for the provision of

engineering services and amenities inresidential township development” (Dept.of Housing)

• “Guidelines for provision of low flow on-

site sanitation systems (LOFLOS)” (WRC) • “Septic tank systems” (CSIR) in addtion, other guidelines on VIP toiletsand solids-free sewer systems are beingprepared.

Where they do not yet exist, governmentwill provide or promote the development ofthe following:

• guidelines for the planning andimplementation of rural sanitation projects

• guidelines for the selection of appropriate

sanitation systems • guidelines for the design and construction

of different sanitation technologies • guidelines for the evaluation of innovative

approaches • capacity to monitor construction standards • training and development of local

entrepreneurs on sanitation programmes.

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6 INSTITUTIONAL AND ORGANISATIONAL FRAMEWORKS

6.1 Sanitation policy principles apply equally to all communities but could vary in approachbetween rural and urban communities.

6.2 Primary responsibility for the provision of household sanitation rests with thehousehold itself.

6.3 Local government is responsible for sanitation services.6.4 Provincial government has the responsibility to ensure that local government functions

effectively with respect to sanitation services.6.5 Central government has the powers to intervene to ensure that minimum levels of

services are maintained.6.6 The Department of Water Affairs and Forestry will take the lead in the promotion of the

sanitation programme, in close co-operation with the Department of Health and theother four departments represented on the National Sanitation Task Team.

6.7 Sanitation improvements cannot be effected in isolation. It is essential that there aresubstantial linkages with other government programmes.

he institutional arrangements for thepromotion and provision of effectivesanitation must be guided by the

Constitution, which stipulates that:

• Local government is, in the first instance,responsible for the provision of servicessuch as water supply and sanitation;

• Provincial government has the

constitutional responsibility for theestablishment and effective functioning oflocal government;

• National government has the powers and

the duty to intervene in matters ofprovincial and local competence to ensurethat minimum standards are maintained.

Given the different stages of developmentof local government it is clear thatinstitutional arrangements will vary inseveral ways: approaches in developingareas will be different from those in wellestablished areas, and rural areas willgenerally have different requirements fromurban areas.

Effectively functioning institutionalarrangements (typically relating to urbansewerage systems) should be retained.Greater emphasis should however begiven to co-ordination between differenttiers of government, the variousgovernment programmes and otherstatutory agencies. Where new

arrangements are needed, the factorswhich influence their design are notedbelow.

Factors determining institutionalarrangements

Promotion and support requirements:Programmes in developing areas mayrequire more attention to ‘soft’ issues suchas community empowerment, promotion,health education and financial assistanceto households. Other support may beneeded to assist emerging entrepreneursto participate.

Financial and economic constraints:Institutional arrangements will differ inthose communities with a financially soundlocal government from those in which localgovernment does not have adequatefinancial means.

Technical and environmental issues:The technologies used where sanitationsystems serve an entire community18 willbe different from those systems whichserve only individual households.Environmentally vulnerable areas willneed special care.

Management requirements: A communalsewerage system requires a dedicatedmanagement system to ensure its ongoing

18 For instance water-borne sewerage systems.

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operation and maintenance. This is lessso for household on-site systems19 whichmay only require emptying or replacementonce every five years, but will still beneeded if such systems are to beeffective.

Linkages with other programmes

Certain other programmes have a directimpact on sanitation provision. Theseinclude:

• the national housing programme in urbanareas, which provides a subsidy forinternal and on-site sanitationinfrastructure to serve house-holds inreceipt of the subsidy;

• the land reform programme, which

includes settlement grants to providedomestic infrastructure;

• the municipal infrastructure programme of

the Department of ConstitutionalDevelopment, which financesinfrastructure (including sanitation) inareas where the local government needsfinancial support to provide it;

• the national public works programme,

which aims to create employment,entrepreneurial opportunities and capacitybuilding while providing infrastructureassets;

• the environmental health programmes of

the Department of Health, which promotesanitation improvements as an essentialcontribution to improved health;

• the integrated pollution control initiative of

the Department of Environmental Affairsand Tourism;

• water supply and water resource

management programmes of theDepartment of Water Affairs and Forestry,which provide the water needed forsewerage systems, but also imposeconstraints by requiring that sanitation beprovided in a manner which is notdetrimental to the quality of the nation'swater resources.

19 These systems could include aqua-privies, VIP toilets,septic tanks, etc.

• the Department of Water Affairs andForestry's community-based water supplyprogrammes, which provide a platform forthe implementation of sanitation activitiesthrough local water and sanitationcommittees supporting the development oflocal government structures.

The sanitation improvementprogramme

This White Paper indicates that in additionto existing conventional municipalarrangements, there is a need for a newprogramme with the goal of achieving asituation in which all South Africans haveaccess to adequate sanitation. To thisend, four specific objectives must be met:

• co-ordinating between the programmes ofdifferent departments and tiers ofgovernment with respect to technical,financial, communications and otherdimensions;

• undertaking pilot activities in support of the

promotion of adequate sanitation systems; • poviding technical, financial and

communications support for theachievement of adequate sanitation forthose communities which are not assistedby existing programmes (described above)and where conventional communalsystems are unlikely (e.g. in rural areas,small towns, peri-urban areas and informalsettlements); and

• training of personnel and building of

capacity at local and provincial levels inorder to extend the programme to allSouth Africans throughout the country.

The design of the programme will beguided by the objectives described above.The range of inputs needed will requirethe proposed programme to continue to bebased on an inter-departmental approach.The management of the programme willbe guided by the National Sanitation TaskTeam comprising of representatives fromthe collaborating departments. To beeffective, it should fall under the guidanceof a national department.

It is has been agreed that the Departmentof Water Affairs and Forestry, through its

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Community Water Supply and Sanitationbranch, will continue to take the lead insetting up the programme. This is due tothe close links a sanitation programmeshould have with the department's watersupply programme, and its commitment topromoting interventions designed to makebasic services accessible to everyone.The Department of Health and healthpersonnel at various levels of governmentwill play a major role in the promotion andeducational outreach aspects of theprogramme.

The programme should have a nationalidentity in order to promote an integratedapproach to improving health, sanitationfacilities and the environment. It shouldstress that individual and communityhealth (including a community’senvironment) are inextricably linked. Thisintegrated approach must include co-operation between all levels ofgovernment and between agencies ateach level of government.

Where financial interventions are required,these may be delivered through existingmechanisms, such as the basic watersupply programmes20 New programmeswill be designed to support and assistembryo institutions of local government,both technically and financially, to deliverservices in a community-based andsustainable manner.

The following sections begin to identify themany stakeholders and their roles in asanitation improvement programme.

Roles and responsibilities of theprivate sector

While the sanitation improvementprogramme described above may requirea high degree of support from governmentagencies, it is intended that such aprogramme will be a full partnershipbetween public and private sector

20 For example using local water committees and localgovernment structures, in programmes prioritised atprovincial level and managed by implementing agentssuch as local government agencies, water boards orNGOs.

organisations. Private sector inputs caninclude:

• preparation of guidelines;• technical assistance;• planning, design and contract supervision;• construction by large and small

contractors;• construction, opoeration and maintenance

of facilities such as sewage works, publictoilets etc;

• preparation of communications materials;• training and capacity building;• supply of materials;• financing; and• monitoring and evaluation.

In addition to involvement in programmeimplementation, there is a growingappreciation of the potential role forprivate sector participation in the financingand operation of water supply andsewerage systems. Government hassupported the preparation of guidelines tofacilitate this process, and is consideringthe regulatory framework required.

Owners of land legally occupied by othersfor example farm owners, landlords ofrental property etc., have a responsibilityto ensure that adequate sanitationfacilities are available.

Role of NGOs

NGOs can play an important role insanitation programmes. Their existingexperience and good contacts atcommunity level will enable them toeffectively carry out activities such as:

• training and capacity building;• using their flexibility to assist communities

with the planning and implementation ofprojects;

• providing health and hygiene educationand sanitation promotion;

• preparing communications materials; and• financing of projects.

Household responsibility

As mentioned before, primaryresponsibility for household sanitationprovision rests with the household itself,and all levels of government are basically

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in the role of facilitating this, or of carryingout those functions which are moreefficiently executed at a community level(or even larger grouping).

Local government levelresponsibilities

Local government responsibilities inrespect of sanitation include:

• provision of communal infrastructure(planning, programming, and financing);

• operation and maintenance ofinfrastructure;

• communication with consumers (agreeingstandards, setting tariffs, collectingrevenues);

• maintenance of public health (healtheducation, pollution prevention andcontrol);

• promotion of development (facilitatingcommunity involvement);

• provision og technical assistance forupgrading on-site systems;

• faciilitating the establishment of andcapacity building of local water andsanitation committees (in rural areas);

• co-operation with others to poolexperience and generate consistentapproaches; and

• reporting to provincial government.

Provincial government levelresponsibilities

In respect of sanitation, provincialgovernment responsibilities include: • provision of technical assistance to local

authorities (engineering advice, capacitybuilding, training);

• distribution of housing subsidies;• environmental management;• co-ordination of regional planning;• mobilisation and co-ordination of regional

training capacity;• promotion of integrated development;• inter-departmental co-ordination;• allocation of provincial funding; and• monitoring progress of the sanitation

programme and the related activities oflocal government.

National government levelresponsibilities

National government responsibilitiesinclude: • co-ordination of all activities;• development of policy and strategy;• setting basic minimum standards and

levels of service;• changes to regulatory framework;• allocation of national funds (funding

criteria);• development of a framework for grants,

loans and technical assistance;• preparation of guidelines;• promotion and advocacy of sanitation

improvements (support programmes); and• monitoring and evaluation.

Other stakeholders

As will be seen in the preceding sectionsof this White Paper, there is a wide rangeof other stakeholders, all of whom have avital role to play. The improvement ofsanitation is everybody’s business andcannot be seen as a government-sponsored top-down programme. Themany role players include: • householders (first and foremost);• local water and sanitation committees (or

local equivalent);• provincial housing boards;• water boards (on behalf of local

government);• contractors (small and large);• materials and equipment suppliers

(stocking or making special items);• non-government organisations (using

existing networks);• consultants (technical, social etc.);• training organisations (technical training

and capacity building);• community workers (motivating community

initiatives);• health workers (promoting, education)• financing institutions (micro-loans, big

project funding);• private sector utility management

companies; and• researchers (monitoring and improving

equipment and approaches).

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SECTION D:LOOKING AHEAD

his section describes the way forward and gives an outline for future implementation.

In order to make adequate sanitation a practical reality to the many people that thispolicy is intended to serve, the National Sanitation Task Team has already started to

develop a framework for implementation which is outlined below.

Implementation approach

The absence of a coherent nationalprogramme to improve communitysanitation has left an obvious legacy.Nearly half of South Africa’s populationdoes not have, within their own homes,the healthy environment promised to themby the Constitution. There is a glaringneed for a structured programme toaddress this problem.

Given the limited practical experience inthe field and the evolving institutionalarrangements at local level, such aprogramme must be flexible enough todevelop and change over time. It mustbuild on the lessons of experience andreinforce the role of local government asthe implementors of service provision.

It is therefore proposed that there be aninitial two-year start-up phase. During thisperiod, there should be an increase infunding to sanitation to start a limitednumber of projects in all of the provinces.Existing pilot projects and research willcontinue, as will the development of thehealth and hygiene and capacity building“software”. The consultation process mustalso continue.

The experience gained from theseactivities will then be used to design andlaunch a full-scale national sanitationprogramme. This programme will aim toacheive the ambitious goal of meeting thebasic sanitation needs of all SouthAfricans within ten years, in accordancewith the development principles set out inthis document.

Development of strategies

The next step is to develop strategies for anational sanitation programme, these willinclude:

• recruitment and training of a number ofkey personnel at national andprovincial levels;

• formation of appropriate institutionalarrangements;

• advocacy at national and provinciallevels;

• planning of promotional health andhygiene education and awarenessprogrammes;

• development of systems to captureand learn from experiences; and

• preparation of guidelines. Regulatory changes

Future actions will include assuming anactive role in some of the processescurrently revising legislation relevant tosanitation, such as the Water Law Review.Proposals on dealing with the legalchanges required in the following areaswill be made:

• environmental legislation;• Public Health Orders and; and• local government bye-laws

Institution building

Attention will be given to ensuring thatsanitation concerns are adequatelyaddressed in other approaches currentlyunderway. These include the review ofwater and health legislation,environmental policy and financingarrangements for service provision.

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The National Sanitation Task Team will becharged with developing an overallimplementation strategy and theorganisational arrangements needed tomake it work. The six departmentsinvolved have taken the lead in co-operative action and this will be continued;the challenge is to repeat this inter-sectoral co-operation at provincial andlocal level to build the multi-disciplinaryapproach which is essential to the successof any sanitation programme.