ABSTRACT
Although increasing access to sanitation facilities was a primary focus of the Millennium Development Goals, the Sustainable Development Goals explicitly include consideration of the entire sanitation chain by introducing safe management of fecal wastes as a normative goal. Safe management of fecal waste has often been omitted from policy discussions that focus on scaling up access to sanitation. However, more toilets mean more wastewater (where water is used as a conveyance) and more fecal sludge, both of which present risks of exposure to excreta-containing pathogens if they are not safely managed.
Unlike the construction of toilets or latrines, which are household-level improvements, management of wastewater and fecal sludges are community issues. There are important disparities between communities in how fecal wastes are managed, and often, important disparities between households in the same community. These disparities in service availability and accessibility often leave the poor without reliable management of waste beyond the toilet.
Inadequate onsite containment of feces can contaminate the local environment and may leave users and nearby residents exposed to excreta, especially during floods. At the community-level, lack of safe fecal sludge management (FSM) options may require users to empty and dispose of latrine pit contents themselves or services may be infrequent and expensive. Often, unserviced facilities are abandoned and new ones are constructed, which leads to less permanent and potentially unsafe sanitary infrastructure. Where FSM services do not exist, the cost of transporting sludges may be prohibitive, and dumping of untreated excreta into drains, surface water, or nearby land may put users and others at risk. Most of these effects are observed at a disproportionately higher rate and have worse consequences in relatively poor communities. Containment and FSM services must accompany the provision of household toilets to prevent additional health risks to the community at large.
