Sanitation in urban and peri-urban areas of Cap-Haitien: the promotion of different latrine options through a social marketing approach

UNIVERSITY OF SOUTHAMPTON

FACULTY OF ENGINEERING, SCIENCE AND MATHEMATICS

SCHOOL OF CIVIL ENGINEERING & THE ENVIRONMENT

INSTITUTE OF IRRIGATION & DEVELOPMENT STUDIES

Sanitation in urban and peri-urban areas of Cap-Haitien, Haiti: The promotion of different latrine options through a social marketing

approach

Rémi Kaupp

December 2006

A dissertation submitted in partial fulfilment of the degree of MSc in

Engineering for Development by instructional course

Abstract

This dissertation presents a study done in Cap-Haitien, Haiti with the non-governmental organisation Oxfam, aiming at analysing the sanitation situation in urban and peri- urban of the city, and putting forward recommendations to implement in a development project.

Urban slums pose unique problems given the high level of poverty, low implication

of public services and lack of infrastructure. Excreta management has a particular inci- dence on water-related diseases, yet sanitation coverage is frequently low in these areas. Some technical solutions exist, but the problems of pit emptying and raising demand for latrines have to be addressed. Social marketing can be a way to raise demand and work towards sustainable sanitation.

A range of tools have been used for the research, including interviews with key infor- mants, field visits, a household survey, a workshop with partner organisations, a focus group discussion to assess the willingness to pay, and a pilot test of an ecological latrine.

Findings indicate that the low existing coverage comes mainly from the inadequa- tion of past and current practices: the outcome of previous supply-led subsidised pro- grammes is an unsustainable sanitation system, with expensive latrines, and unreliable and unsafe emptying services.

Alternatives would need to be suited to the particular constraints expressed in each area. Ecological sanitation could have some potential where urban agriculture is prac- tised, with a simple model such as the Arborloo. In low-lying areas with higher hous- ing density, improved products such as small low-cost latrines could raise demand, but would need to be coupled with a reliable emptying system. First assessments of the will- ingness to pay are encouraging but need further research; more links between the public and private sectors would also be necessary, especially regarding the final disposal.

This research encourages Oxfam to investigate the sanitation marketing option, while still being flexible to adapt solutions to the local context. Future research could also be done to compare Cap-Haitien's situation with other cities of the developing world.

Rémi Kaupp

Acknowledgements

I first thank Oxfam for making this placement happen, and in particular my supervisor

Tim Forster who set up the study.

I am deeply indebted to Guettie Noël who acted not only as my translator, but also

as my assistant and facilitator during the study, and whose work also helped me to understand the Haitian culture; many thanks also go to her welcoming family.

I am grateful to Sonia Heaven, my supervisor in the United Kingdom, for her contin- uous support and advice, and to Ben Fawcett for sharing his experience and suggestions.

This research was to a great extent done in collaboration with the London School

of Hygiene and Tropical Medicine, and in particular with Steven Sugden who kindly accepted to come to Cap-Haitien, and Beth Scott who advised me with the demand tool.

Oxfam staff in Cap-Haitien was always supportive and contributed to the success of

the research: many thanks to Laurence Hamai, Samuel Mondestin, Anne-Flore Leroy, Hernal Cadet, Jean-Reynald Etienne, Valery Laguerre, Berly Raphaël, Nadège Joanis Noël, Gemps Célestin and to Haiti programme manager Yolette Etienne.

I received useful advice from the WASTE institute, thank you to Arnold van de Klun- dert and Mirjam Geurts.

Final thanks go to inhabitants of Cap-Haitien who participated in the survey, those who accepted to spend some time for interviews, women from Fanm pa chita for their participation in the focus group discussion, and the Roboam family for accepting to test

the Arborloo.

Rémi Kaupp

^Contents

1 Introduction 9

1.1 Context of research . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1.2 Sanitation and urban slums . . . . . . . . . . . . . . . . . . . . . . . . 12

1.3 Structure of the dissertation . . . . . . . . . . . . . . . . . . . . . . . . 13

2 Background: Sanitation and Marketing 15

2.1 Approaches to sanitation . . . . . . . . . . . . . . . . . . . . . . . . . 15

2.2		Sanitation marketing	. . . . . . . . . . . . . . . . . . . . . . . . . . .		18
2.3		Latrine pit emptying	. . . . . . . . . . . . . . . . . . . . . . . . . . .		20
3	Objectives			22
4	Description of research			23

4.1 Programme . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

4.2 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

4.3 Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

5 Results and analysis 32

5.1 Areas of the city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

5.2 Sanitation situation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

5.3 Inappropriate practices . . . . . . . . . . . . . . . . . . . . . . . . . . 44

5.4 Alternative options . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

6 Discussion 56

6.1 Limitations of the research tools . . . . . . . . . . . . . . . . . . . . . 56

6.2 Is sanitation a priority? . . . . . . . . . . . . . . . . . . . . . . . . . . 58

7 Conclusion 61

7.1 Achievements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

7.2	Recommendations for the project . . . . . . . . . . . . . . . . . . . . .	62
7.3	Future research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	63

References 64

Rémi Kaupp Contents

A	List of appendices		67
B	Semi-structured interviews		68
C	Focus group discussion		69
D	Sustainable excreta disposal		70
E	MDG calculations		72
E.1		Population and coverage estimates . . . . . . . . . . . . . . . . . . . .		72
E.2		Cost of a latrine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		73
E.3		Total cost to achieve the MDGs . . . . . . . . . . . . . . . . . . . . . .		74

F Product-service package 75

F.1 Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

F.2		Rough break even and financial viability calculations . . . . . . . . . .		80
F.3		Public Private Partnership (PPP) . . . . . . . . . . . . . . . . . . . . .		81
G	Survey questionnaire		82
H	Survey detailed results		91

Rémi Kaupp

^{List of Figures}

1.1 Map of Haiti . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

1.2 Aerial view of Cap-Haitien. . . . . . . . . . . . . . . . . . . . . . . . . 11

1.3	View of Cap-Haitien above Mansui, looking towards the East.	. . . . .	12
2.1	The Arborloo . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . .	18

2.2 The VacuTug in Dar-Es-Salaam . . . . . . . . . . . . . . . . . . . . . 21

2.3 A «frogman» in a latrine pit, in Dar-Es-Salaam . . . . . . . . . . . . . . 21

5.1	Location of surveyed areas in the city . . . . . . . . . . . . . . . . . .	35
5.2	Open defecation area in Shada. . . . . . . . . . . . . . . . . . . . . . .	37
5.3	Public toilet in Shada. . . . . . . . . . . . . . . . . . . . . . . . . . . .	38
5.4	Communal toilets in Nan Bannann. . . . . . . . . . . . . . . . . . . . .	39

5.5 A latrine in Mansui, built by the USAID-financed programe. . . . . . . 40

5.6	Overhung latrines in Northern Shada.	. . . . . . . . . . . . . . . . . .	42
5.7	Graphical projections for the MDGs .	. . . . . . . . . . . . . . . . . .	48

5.8 The finished test Arborloo in Mansui . . . . . . . . . . . . . . . . . . . 51

5.9 Old small vacuum tanker, belonging to the MSPP. . . . . . . . . . . . . 53

6.1 Housing problems in Petite-Anse. . . . . . . . . . . . . . . . . . . . . 59

Illustrations by the author, except:

· Figure 1.1 from the CIA World FactBook,

· Figures 1.2 and 5.1 from UTSIG/MPCE and Oxfam,

· Figure 2.1 by Peter Morgan,

· Figures 2.2 and 2.3 by Steven Sugden.

Rémi Kaupp

^{List of Tables}

5.1	Summary of differences between the areas	. . . . . . . . . . . . . . .		34
5.2	Defecation methods in each area . . . . . .	. . . . . . . . . . . . . . .		36
5.3	Sustainability of current sanitation options, result from the Oxfam-GTIH-
	MSPP workshop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		45
E.1	Population and latrine coverage estimates . . . . . . . . . . . . . . . .		73
E.2	Cost of some elements of a «standard» latrine . . . . . . . . . . . . . .		74
E.3	Total cost to achieve the MDGS in Cap-Haitien . . . . . . . . . . . . .		74
F.1	Components of a low-cost latrine . . . . . . . . . . . . . . . . . . . . .		76
F.2	Detailed pricing of a low-cost latrine elements . . . . . . . . . . . . . .		77
F.3	Financial viability calculations . . . . . . . . . . . . . . . . . . . . . .		80

^Glossary

Arborloo A type of ecological latrine, in which a fruit tree is planted in the pit after use; also known as the «single-pit walking latrine».

Bayakou People emptying pits manually in Cap-Haitien.

Gourde The local currency (also written Gde or HTG), fairly stable during the re- search at 38-39 Gdes = US$ 1, often rounded at 40 Gdes = US$ 1. Haitians frequently count sums bigger than 5 Gourdes using the non-existent Haitian Dollar (HT$), with 5 Gdes = HT$ 1, and HT$ 7,7 - 8 = US$ 1. During in- terviews and discussions, the Haitian dollar was the preferred currency.

For comparison, the following prices could be found during the research:

· A plastic bag = 1 Gde

· A bucket (20 litres) of water at a handpump = 2 Gdes

· A tap-tap (bus) ride = 5 Gdes

· A bottle of Coca-Cola = 25 Gdes

· A standard lunch (rice, beans, some chicken) = 50 Gdes

Rémi Kaupp List of Tables

· The following daily wages could also be found: a barrow boy 100

Gdes (US$ 2.5), unskilled construction labour 150-250 Gdes (US$

3.75 - 6.25), skilled mason 300 - 400 Gdes (US$ 7.5 - 10)

List of abbreviations

AMPB Association de Militants Progressistes de Bel-Air

DIPECHO Disaster Prepared Plan for the European Commission Humanitarian Aid

Office

EPPLS Entreprise Publique de Promotion de Logements Sociaux - Public Enter- prise for Promoting Social Housing

EU European Union

FGD Focus Group Discussion

GDP Gross Domestic Product

GTIH Groupement Technologie Intermédiaire d'Haïti - Intermediate Technology

Group Haiti (note: nothing to do with ITDG)

KLPS Komite lokal de Proteksyon sivil - Local Civil Protection Committees

LSHTM London School of Hygiene and Tropical Medicine

MDG Millennium Development Goals

MINUSTAH Mission des Nations Unies pour la STAbilisation en Haïti - United Na- tions Mission for Stabilisation in Haiti.

MSPP Ministère de la Santé Publique et de la Population - Ministry for Public

Health and Population

PHAST Participatory Hygiene And Sanitation Transformation PROTOS PROjectgroep Technische OntwikkelingsSamenwerking vzw NGO Non-Governmental Organisation

PPP Public-Private Partnerships

WSP Water and Sanitation Programme

WTP Willingness To Pay

Rémi Kaupp