WAT E R G L O B A L P R A C T I C E Evaluating the Potential of Container-Based Sanitation About the Water Global Practice Launched in 2014, the World Bank Group’s Water Global Practice brings together financing, knowledge, and implementation in one platform. By combining the Bank’s global knowledge with country investments, this model generates more firepower for transformational solutions to help countries grow sustainably. Please visit us at www.worldbank.org/water or follow us on Twitter @WorldBankWater. About GWSP This publication received the support of the Global Water Security & Sanitation Partnership (GWSP). GWSP is a multidonor trust fund administered by the World Bank’s Water Global Practice and supported by Australia’s Department of Foreign Affairs and Trade; the Bill & Melinda Gates Foundation; The Netherlands’ Ministry of Foreign Trade and Development Cooperation; Norway’s Ministry of Foreign Affairs; the Rockefeller Foundation; the Swedish International Development Cooperation Agency; Switzerland’s State Secretariat for Economic Affairs; the Swiss Agency for Development and Cooperation; Irish Aid; and the U.K. Department for International Development. Please visit us at www.worldbank.org/gwsp or follow us on Twitter #gwsp. Evaluating the Potential of Container-Based Sanitation © 2019 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington, DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of ­ The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Please cite the work as follows: World Bank. 2019. “Evaluating the Potential of Container-Based Sanitation.” World Bank, Washington, DC. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The  World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: pubrights@ worldbank.org. Cover photos: Left, © Sanergy; center, © Sasha Kramer/SOIL; right, © Julian Parker/x-runner. Cover design: Bill Pragluski, Critical Stages, LLC. C ONT E NTS ACKNOWLEDGMENTS • v EVALUATING THE POTENTIAL OF CONTAINER-BASED SANITATION: AN OVERVIEW • vi EXECUTIVE SUMMARY • vii ABBREVIATIONS • xix INTRODUCTION • 1 The Urban Sanitation Challenge • 1 What Are CBS Approaches? • 2 Report Objectives • 2 Study Methodology • 3 Notes • 5 References • 5 CHAPTER 1: OVERVIEW OF CBS SERVICE MODELS • 6 A Short History of CBS • 6 Where Have CBS Approaches Been Developed? • 9 CBS Service Models across the Sanitation Service Chain • 9 Notes • 18 References • 18 CHAPTER 2: LEGAL AND POLICY ENVIRONMENT FOR CBS SERVICES • 19 Overall Legal Environment for Sanitation • 19 Legal Regimes for CBS Services • 19 Regulation of CBS Services • 20 Notes • 23 References • 23 CHAPTER 3:   CBS SERVICE PERFORMANCE • 24 CBS Service Customer Growth • 24 Value of CBS Services to Customers and the Community • 25 Notes • 32 References • 32 Evaluating the Potential of Container-Based Sanitation iii CHAPTER 4: FINANCIAL PERFORMANCE • 33 Revenues from User Charges and Reuse Product Sales Cover a Small Portion of Costs • 33 CBS Service Providers Deploy a Mix of Strategies to Reduce Costs • 35 Revenues from Reuse Are Also Seen by Some of the CBS Service Providers as a Way to Reduce the External Funding Requirement • 36 More Reliable Sources of Subsidies Will Likely Be Required to Sustain the Operations • 36 Notes • 37 References • 37 CHAPTER 5:  EMERGING LESSONS AND AREAS FOR FUTURE WORK • 38 Emerging Lessons • 38 Areas for Further Analysis • 39 Notes • 40 References • 40 APPENDIX A:  PEOPLE INTERVIEWED • 41 Box 1.1 The CBS Alliance • 7 Figures 1.1 CBS Service Providers along the Sanitation Service Chain vs. Conventional Sanitation Service Providers • 10 1.2 Summary Description of Four CBS Service Providers along the Sanitation Service Chain (as of April–May 2017) • 11 2.1 CBS Regulatory Bodies, by Country and Typical Regulation of Alternatives • 21 3.1 Customer Growth for CBS Service Providers Examined in Case Studies (as of May 2017) • 25 Photo 1.1 Examples of CBS Toilets • 14 Tables ES.1 Summary of Potential Advantages and Limitations of CBS Services • xv I.1 Information Collected from Stakeholders for the Case Studies • 4 1.1 Key Features of CBS Service Providers (as of May 2017) • 8 1.2 Reuse Activities: Processes and Products • 18 3.1 Safety and Potential Reach of Sanitation Services: Comparison between CBS Services and Safest Viable Alternatives in CBS Service Providers’ Areas of Service • 27 3.2 Tariff Charged to Users for Sanitation Services: Comparison between Providers and Alternatives • 29 iv Evaluating the Potential of Container-Based Sanitation A C K NO W L E DG M E NTS This report was written by Sophie Trémolet (Senior Economist, World Bank) and Julian Parker (Independent Consultant), with the support of Ruth Kennedy-Walker (Water Supply and Sanitation Specialist, World Bank) and  Clémentine Stip (Operations Analyst, World Bank), and was based on case study research conducted by Julian Parker and Adrien Mazeau (Independent Consultant). The research was developed with support from Martin Gambrill (Lead Water and Sanitation Specialist, World Bank) and benefited from inputs from Odete Muximpua (Water and Sanitation Specialist, World Bank) and Rebecca Gilsdorf (Young Professional, World Bank). Within the World Bank Water Global Practice, initial impetus for the work was provided by Alex Bakalian (Practice Manager) and Jennifer Sara (Director). World Bank peer reviewers for the work included Jean-Martin Brault (Senior Water and Sanitation Specialist), Carmen Yee-Batista (Senior Water Supply and Sanitation Specialist), Andre Herzog (Senior Urban Specialist), Lewnida Sara (Operations Analyst), and Caroline Van den Berg (Lead Water Economist). Comments were also received from Luis Andres (Lead Economist, World Bank). We are grateful for the support of Maria-Angelica Sotomayor (Practice Manager, Global Programs Unit, World Bank) in finalizing the outputs. The authors are grateful to the World Bank teams that have supported the case study research at the country level, who have been acknowledged in the individual country reports. Special thanks go to the CBS Alliance members who provided inputs into the design of the research and reviewed out- puts, including Kory Russel and Tracey Keatman (CBS Alliance); Sasha Kramer, Nick Preneta, Erica Lloyd, and Leah Jean (Sustainable Organic Integrated Livelihoods [SOIL]); David Auerbach, Lindsay Stradley, Sanj Sanampudi, and Katie Wartman (Sanergy); Isabel Medem and Raúl Briceño (x-runner); Virginia Gardiner and Mary Roach (Loowatt); Peter Townsley (Clean Team); and Emily Woods and Andrew Foote (Sanivation). In addition, some of the CBS funders have provided key insights, including Louis Boorstin (Osprey Foundation), Régis Garandeau (Vitol Foundation), and Paul Gunstensen (Stone Family Foundation). Kate Medlicott and Sophie Boisson (World Health Organization) also provided valuable inputs, as well as Doulaye Kone and Jan-Willem Rosen- boom (Bill & Melinda Gates Foundation). Comments on initial drafts and the methodology were helpfully provided by independent consultants Jon Lane and Peter Hawkins, as well as the London School of Hygiene and Tropical Medicine PhD candidate Ian Ross. Contri- butions from Georges Mikhael (Aguaconsult), Syeda Zaki (Grand Challenges Canada), Vikki Bolam (Lixil), Perry Rivera (Manila Water), Sandy Rodgers (Toilet Board Coalition), Juliet Willetts and Cynthia Mitchell (ISF-UTS), and Isabel Blackett (independent consultant) were also very gratefully received. Evaluating the Potential of Container-Based Sanitation v E VALUATING TH E P OT E NTIAL OF C ONTAIN E R - BASE D SANITATION: AN OV ERVIE W The World Bank Water Global Practice (WGP) has to support Bank teams and their clients when engaging developed an approach to urban sanitation based on in CWIS. One of the aims of this work is to explore inno- citywide inclusive sanitation (CWIS) principles, which vative approaches to provide safely managed sanitation have been developed in conjunction with sector part- services along the whole service chain and to support cli- ners (Bill & Melinda Gates Foundation et al., 2017). This ents in identifying when such options might make sense. approach aims to shift the paradigm around urban sani- The study “Evaluating the Potential for Container-Based tation approaches in World Bank engagements, promot- Sanitation” aims to answer some of these questions for ing the following principles: container-based sanitation (CBS), an emerging sanita- tion approach. • Everybody benefits from adequate sanitation service delivery outcomes. ­ The objective of this study is to document and assess • Human waste is safely managed along the whole ­ xisting CBS approaches, with a particular focus on eval- e sanitation service chain. uating their safety, reliability, affordability, and financial viability. The report also seeks to identify the circum- • Comprehensive approaches to sanitation improve- stances in which CBS approaches are most appropriate ments are deployed, with long-term planning, and whether they could be considered as part of a port- technical innovation, institutional reforms, and folio of options for CWIS. The study was motivated by financial mobilization. growing interest in the emerging CBS experiences and • A diversity of technical solutions, which are adap- by the fact that many governments, city authorities, and tive, mixed, and incremental, is embraced. financing entities are often not familiar with the approach. • Effective resource recovery and reuse is considered. • Cities demonstrate political will and technical and The study builds on four case studies (Sanergy, ­ Nairobi, managerial leadership, and they identify new and Kenya; Sustainable Organic Integrated Livelihoods creative ways of funding sanitation. [SOIL], Cap-Haitien, Haiti; Clean Team, Kumasi, Ghana; and x-runner, Lima, Peru) to provide insights into these • Both on-site sanitation and sewerage solutions, questions. The present document is one of these four in either centralized or decentralized systems, are case studies. The full suite of documents is available at considered to better respond to realities faced in www.worldbank.org/cbs. cities. • Complementary services (including water supply, drainage, greywater, and solid waste) are considered. Reference As part of the implementation of these principles, the Bill & Melinda Gates Foundation, Emory University, The University of Leeds, WaterAid, Plan International, and World Bank. 2017. WGP is developing a suite of tools and other material Citywide Inclusive Sanitation: A Call to Action. vi Evaluating the Potential of Container-Based Sanitation E XE C UTIV E SU M M ARY Urban population growth in many developing countries having to build a sanitation facility, households (or outpaces gains in improved sanitation access and ser- public toilet operators) can sign up for a service. The vices. In such circumstances, the traditional approach CBS service provider then installs a toilet with seal- to urban sanitation, premised on extending sewerage able excreta containers (also referred to as cartridges) networks and building wastewater treatment (WWT) and commits to emptying them (that is, removing and plants, will not be sufficient to deliver citywide sanita- replacing them with clean ones) on a regular basis. CBS tion services for all. approaches, therefore, focus on providing a sanitation service rather than on just providing an infrastructure Alternative approaches are needed to deliver adequate intervention. and inclusive sanitation services across the full sanitation service chain.1 Informal urban settings pose particular CBS approaches provide a sanitation response in situ- challenges in the rollout of sanitation services, such as ations facing some or all of the challenges mentioned difficult access; lack of land tenure or space to build a above, as well as in emergency situations and in refugee sanitation solution; often challenging physical and topo- camps, where they can be deployed rapidly without the graphical conditions, such as rocky soil, proximity to need for building permanent infrastructure. Although water bodies, and high-water tables; lack of water sup- this kind of approach remains relatively new and has ply; and/or regular exposure to flooding. Approaches not yet been applied at significant scale, it warrants more are needed to meet these challenges so that the popula- investigation regarding its potential place in a portfolio tion living in informal settings, who is often among the of solutions for a citywide inclusive sanitation (CWIS) most vulnerable, can benefit from adequate sanitation approach. services. As stated in a Citywide Inclusive Sanitation: A Call to Action, released by the World Bank jointly with a number of other sector institutions, delivering safe Report Objectives management along the whole urban sanitation service chain calls for “adaptive, expandable, decentralized and This report aims to document and assess existing CBS cost-effective approaches, mixing onsite and sewerage approaches, with a particular focus on evaluating their solutions, which can be resilient to external economic, safety, reliability, affordability, and financial viability. demographic and environmental shocks” (2017). The report also seeks to identify circumstances in which CBS approaches are most appropriate and whether they In the past 10 years, container-based sanitation (CBS) could be considered as part of CWIS. approaches have emerged as an alternative service approach for the urban poor to those provided by sew- The report is based on a rapid landscaping study that ers or by on-site sanitation (OSS) systems. CBS consists mapped where CBS approaches have been introduced of an end-to-end service—that is, one provided along and reviewed their performance based on available the whole sanitation service chain—that collects excreta information. Four CBS service providers were selected hygienically from toilets designed with sealable, remov- for more in-depth case studies: Sanergy (Kenya), Sus- able containers and strives to ensure that the excreta tainable Organic Integrated Livelihoods (SOIL) (Haiti), is safely treated, disposed of, and reused.2 Rather than Clean Team (Ghana), and x-runner (Peru). These case Evaluating the Potential of Container-Based Sanitation vii studies are available as stand-alone reports (available in Kenya in 2010, SOIL in Haiti in 2011 (after having at www.worldbank.org/cbs). The present report builds experimented with the model in a humanitarian con- on the main findings and presents lessons learned from text in the country in 2009), Clean Team in Ghana in these experiences aimed at governments, funders, and 2011, x-runner in Peru and Sanivation in Kenya in other stakeholders who may be interested in incorporat- 2012, and Loowatt in Madagascar in 2014. Other service ing CBS into a portfolio of CWIS solutions. providers have since followed or are in the process of developing their own models, including a large private Independent consultants conducted the case studies, utility, Manila Water, which has piloted a CBS service with initial field work done in early 2017. Methods for hard-to-reach areas where on-site or sewerage-based include reviews of existing literature, site observations, solutions have proved difficult to implement. Other CBS and extensive interviews (through focus groups) with service providers are at an early piloting stage and/or do CBS service providers and local stakeholders, includ- not yet have well-developed business models.4 ing national and local authorities, service users, and service funders. No comprehensive surveys could be The different CBS service providers work in a vari- undertaken, however, due to time limitations. Data and ety of country contexts, and all are seeking to develop documents were collected and analyzed until May 2017, self-sustaining business models while relying on a mix of though major developments and updates through May public, philanthropic, and private funding sources. The 2018 are reflected. early pioneers, who are also the largest service provid- ers, came together in late 2016 to form the CBS Alliance to advocate for CBS approaches and to better structure A Brief History of CBS Services CBS service provision by promoting, for example, com- mon standards and guidelines.5 A group of CBS entrepreneurs initiated implementation of their businesses in the early 2010s as they strived to identify safe sanitation solutions for the urban poor with Overview of CBS Service Characteristics the potential to meet four critical obstacles:3 The main target market for CBS services are the urban • The high cost and technical challenges associated poor, who typically live in densely packed settlements, with installing conventional sewerage networks in in rented accommodations, or with no formal land dense and informal urban areas; title. The portable nature of CBS as a sanitation approach makes it appealing in these contexts as it requires lit- • Severe physical space constraints for installing and tle space and limited or no in-house construction. In emptying OSS installations; some cases, potential customers who live in single-room • Low political priority of sanitation for the urban dwellings may have insufficient space to install a CBS poor, leading to low investment; and household toilet, thereby rendering single-household • Poor and unreliable availability of water supply, CBS responses unfeasible. In such conditions, shared which has a direct impact on the amount of black- CBS approaches have emerged, such as the Fresh Life water and wastewater generated by a household Toilets from operators who have entered in franchising as well as whether there is sufficient wastewater vol- agreements with Sanergy in Nairobi. ume to effectively flush household waste to sewers. CBS service providers have made different choices A number of CBS service providers launched their oper- regarding which segment of the sanitation service chain ations less than a decade ago: Sanergy started operating to tackle. Those reviewed for this study were shown to viii Evaluating the Potential of Container-Based Sanitation maintain tight control over the containment, emptying, usually temporarily stored and consolidated at one or and transport steps of the sanitation chain. A number of more points (transfer stations) before being taken to the CBS service providers operate across the whole sanita- treatment site. tion service chain, treating the feces for reuse, whereas others have chosen to focus on collection and emptying. CBS service providers have had to adapt their businesses Still, some sanitation issues remain beyond the scope to the limited and fragile cash flows of the urban poor, of CBS approaches to date—for example, none of the so they have developed a variety of payment plans to CBS service providers assessed provide services for the smooth out sanitation payments over time. management of household greywater. This means that The policy and regulatory framework for CBS services in areas with high water consumption, additional grey- is unequally developed. CBS is a functionally distinct water management solutions need to be established to category of sanitation, but it has yet to be recognized as reduce the risks of disease and nuisance spreading. such by most policymakers and regulators as it is still CBS approaches can be deployed with different types of a relatively new approach. Its association with bucket toilets (seated or squat, shared or private) to respond to latrines among some policymakers in Ghana and else- customer preferences. Most CBS toilets are seated porta- where has left CBS in a legal gray area.7 ble units that are placed inside the household. Sanergy’s service involves shared squat toilets, and Loowatt has The recognition of CBS as a distinct category of solutions for use in homes and in external superstructures. improved sanitation in Kenya has made it more accept- All but one of the service providers use urine-diverting able to communities and local authorities and provides systems, though they do not usually collect the urine a strong basis for its development. As the Kenya Envi- separately nor do they try to reuse it, given the weight of ronmental Sanitation and Hygiene Policy (KESHP) urine and the consequent cost of transporting it for treat- 2016–30 emphasizes the importance of appropriate and ment or reuse.6 In those cases, households usually collect affordable technologies and contains a list of technology the urine separately and throw it in nearby drains or exist- options that includes the cartridge-based toilet, county ing pit latrines, where available. Sanergy and Sanivation governments in Kenya are increasingly considering CBS collect the urine separately. Sanergy currently disposes of as part of their portfolio of sanitation options. In other it in nearby sewers and does not reuse it while Sanivation places, such as Haiti, policymakers consider CBS to be a infiltrates it at their treatment site. The CBS service pro- transitional solution, providing them with more time to viders collect the feces (or, in the case of Loowatt, Sanergy, identify alternatives for the long term. and Sanivation, excreta) either from within the customer’s Existing regulation of CBS services does not currently home (or the public toilet), at the doorstep, or at a drop- focus on the activities of households or toilet opera- off point, depending on the physical constraints of the tors (in the latter case, for Sanergy), leaving the service settlement in question and on customer preference. providers to self-regulate this component. Adequate Various modes of transportation are used to take the regulation of CBS services would require norms and collected feces/excreta to the treatment site, depend- oversight of the quality of the containers and the time- ing upon the terrain and the road access, but it usually liness and quality/effectiveness of their emptying, the involves a combination of hand carriages, handcarts, quality and timing of hygiene promotion by the CBS three-wheeled transporters (auto rickshaws or tuk tuks), service provider, the frequency and effectiveness of mon- tractor-trailers, flatbed trucks, and box trucks. To opti- itoring of households’ behavior by the CBS ­provider, and mize the transportation system, the collected feces is the behavior of households or private toilet operators. Evaluating the Potential of Container-Based Sanitation ix In addition, an explicit regulatory framework for the that are  mitigated through clear internal procedures reuse of treated feces in agriculture would enable some for CBS service providers’ personnel regarding pro- of the CBS service providers who treat excreta to high tection, as well as through the careful design and use standards for reuse, such as x-runner, to be able to effec- double-sealed containers. In some cases, the local of ­ tively market their products. context and/or customer preferences may dictate the participation of customers in the removal from the The CBS Alliance is looking to provide an anchor for the household, transportation, and subsequent emptying development of shared CBS metrics and performance of the containers. However, this participation comes indicators. In collaboration with the World Health with potential health risks due to possible exposure to Organization (WHO), the CBS Alliance and its mem- feces, so monitoring, follow-up hygiene promotion, bers worked on the development of Sanitation Safety and enforcement of sanctions by CBS service providers Plans (SSPs) for their operations in order to provide for any improper operation need to be strictly applied stronger assurance to relevant authorities and the public in these cases. Out of the four case studies conducted that CBS services can be managed in a safe way. In the for this study, only x-runner involves customers in the future, it is looking to develop overall service standards emptying and transporting, with customers manually ­ to support the development of public sector contracts taking their containers to a locker for pickup or to a col- and results-based financing models and, ultimately, lection truck as it passes through the community. enable broader replication of CBS service models. These service standards would also enable the benchmarking The study found that treatment and resource recovery of service quality across different service providers— processes operated by CBS service providers are provid- and countries—and would help ensure that consistent ing a high level of treatment when compared to what is high-quality services are promoted. Potential perfor- currently practiced in the areas where they operate. For mance indicators could include the percentage of missed example, in the case of SOIL, all of the excreta collected collections, the volume of feces or excreta that is safely is transformed into compost through a carefully moni- collected and treated, the volume of feces or excreta that tored thermophilic composting process that meets the is reused (independently of whether it is sold), or the WHO’s standards for safe treatment of feces. The final volume of reuse products sold. compost is then sold to recover some of the costs of the treatment process (Remington et al. 2016). Services provided by existing CBS providers are con- sidered safe but have some areas for improvement. Three of the four CBS service providers reviewed (SOIL, The observations undertaken for this study found that Sanergy, and x-runner) use composting to ensure that CBS sanitation services can be considered safe as the fecal pathogens are eliminated from the feces before end feces is double-sealed throughout most of the emptying use/disposal. Clean Team in Ghana disposes of it in a and transport processes to reduce exposure risks.8 These landfill managed by the municipality. The level of treat- observations were supported by external assessments ment provided by the CBS service providers was found undertaken by academics in the case of SOIL (Reming- to be higher than the treatment applied to feces and ton et al. 2016; Sklar and Faustin 2017). ­ septage in the areas where they provide services, due to the lack of dedicated fecal sludge treatment facilities in The process is safer when the feces or excreta is handled these areas. by only trained and professional personnel. As with other fecal sludge management (FSM) solutions, there Reliability is high, but clear contingency plans are are health risks associated with the handling process needed. CBS collection services were assessed to be x Evaluating the Potential of Container-Based Sanitation reliable with few missed collections.9 The study found some service users saw the fact that Fresh Life Toilets that in situations when collections were missed, they are waterless as a distinct advantage in a water-scarce were remedied as soon as they were reported, even environment where there is no piped water and, conse- though not all service providers maintain detailed quently, water for household use is costly and needs to records on performance indicators. In the case of San- be hauled over considerable distances. ergy, the number of complaints and the time taken to respond to such complaints are systematically tracked, Customer satisfaction with existing services is high. and each type of complaint has a target timeframe for This finding, which held in all four cases, was based on resolution. The customers interviewed for the study did focus group discussions, as well as results of surveys not raise complaints about the reliability of collections. undertaken by CBS service providers themselves.9 The CBS services that were assessed had well-functioning The study also found that CBS service providers should and responsive customer feedback mechanisms. In sit- have contingency plans in place for countering any uations where customers had been waiting a long time possible severe disruptions in order to allow them to for sewerage network expansion or for the provision of continue providing services as much as possible. It was other adequate sanitation services (such as in Haiti or in not clear from the assessment whether CBS service Nairobi), customers did not see CBS services as a transi- providers have clear strategies for coping with poten- tory solution but rather as a long-term, reliable solution. tial disruptions to their operations, which could occur due to staffing issues, natural disasters (such as hurri- The four CBS providers analyzed under the study adopt canes or floods) or manmade disasters (such as riots or market-based strategies to gain new customers, increase civil conflict), epidemics, or interruptions to external the density of their services, and reduce costs. These funding that is critical for continued service provision. approaches include a strong focus on understanding Although these might be low-probability events, their and responding to demand for their services by closely potential to disrupt collections makes them a threat to studying the needs of potential users, adapting their the long-term acceptance of CBS, whereas contingency services to meet those needs, and ensuring that cus- ­ plans involving local public health departments, and tomer outreach approaches engage with potential new other entities as appropriate, could help make CBS ser- customers. The process of signing up new customers for vices an asset in high-density, poor urban areas that are the services, referred to by the four CBS providers as prone to such unexpected events. During epidemics of “sales,” can be conducted by staff in charge of collection infectious diseases, CBS collection staff face high expo- or by dedicated sales agents motivated through individ- sure, but they also provide a potential source of early ual incentives or collective incentives at the level of a warning/­ surveillance information. Through their direct sales team. All four of the CBS providers were found to and regular contact with households, they could quickly offer financial incentives to existing customers for suc- inform the appropriate institutional/regulatory bodies if cessful referrals, which is a growing focus of their modus infectious diseases symptoms arise or become prevalent. operandi to increase subscription levels. The goal is to increase coverage density in the areas where they are CBS services are resilient to floods and drought. CBS already operational, specifically by targeting slow adopt- services can be more resilient to climate variations than ers within this market. other solutions, particularly to floods and droughts. In Haiti, CBS service users highlighted that they could CBS services are considered to be priced similarly to continue to use their toilets during floods, whereas tra- the main sanitation alternatives in their service areas, ditional latrines would become unusable. In Nairobi, such as public toilets connected to sewers or lined pit Evaluating the Potential of Container-Based Sanitation xi latrines with associated FSM services. However, it is dif- services in similar geographic areas, such as sewerage ficult to make a direct comparison due to differences in services or OSS and FSM, face similar challenges in the cost structures and the services provided. All CBS recovering their costs and tend to receive subsidies, providers charge different amounts, collect them in either in the form of cross-subsidies from water supply different ways, and use different approaches to service services or from government sources. Mobilizing reve- delivery (for example, emptying frequency, emptying nues from the sale of reuse products can be an option process, and cover material). Irrespective of these differ- for covering some or all of the shortfall, but in the cases ences, one common advantage of the CBS model is that where the financial situation of the CBS service providers monthly charges can be a convenient way for households was reviewed, they had not proven sufficient to cover a to smooth out the cost of paying for a reliable sanitation substantial portion of the operating costs up to this point. solution over time. This eliminates the need for house- holds to mobilize substantial funding or to get credit for The assessment found that service fees could potentially initial installation costs for OSS solutions and for the be increased to cover a greater portion of total costs. The subsequent emptying costs, which is often a significant CBS service providers reviewed have variable experi- barrier, limiting access to pit latrines and septic tanks, ences with such increases in charges but, overall, have for example. Sewerage services are usually similarly had limited negative impact on demand for their s ­ ervices. charged on a monthly basis, though initial sewerage For example, Clean Team increased its prices in April connection costs can be unaffordable, particularly when 2017 (by 8.5 percent for mobile money subscribers and network extensions are necessary and in-house plumb- by 23 percent for direct payment subscribers) without ing adaptions are needed. Complementary approaches a noticeable reduction in the number of their custom- can also be deployed to smooth out cash flows over time, ers. SOIL began providing its service for free and then such as facilitated access to credit. increased the price to G 100 per month (US$1.50) within six months but nevertheless maintained 71  ­ percent of All of the CBS service providers reviewed in the case their customers; further rate increases followed (from studies are funded through a mix of user charges for G 250 to G 350, or US$4 to US$5.65 in Port-au-Prince) the toilet services, revenues from reuse activities (where with an 80 percent retention rate. these are undertaken), and external funding. Of the four CBS service providers reviewed, all of them are receiv- All four have strived to reduce their costs and to improve ing significant external support (covering between 80 to the efficiency of their operations by focusing on the geo- 90 percent of their total costs) in the form of funds and graphical areas where they are already operational for technical assistance from private foundations, individual new sales, rather than opening in new areas. This allows donors, and, in the case of Clean Team, in-kind from a them to densify services and generate economies of scale government agency. Reliance on such sources of funding in existing service areas. They all have deployed strate- creates an operational risk should these funds cease. gies to improve the efficiency of their services to reduce their dependency on external subsidies—for example, The proportion of total CBS service costs covered by improving the usage of transport trucks (x-runner) by  revenues is still small (currently between 10 and and reducing the number of weekly collections (SOIL). 19 percent).10 None of the CBS service providers reviewed were able to recover their full costs from the revenues Current experience suggests that profitable CBS sani- linked to their activities, a situation that is likely to per- tation services along the whole sanitation service chain sist in the foreseeable future despite substantial efforts are likely to be the exception at present. Given this, pre- to reduce costs and boost revenues. Other sanitation dictable subsidies will likely be needed for CBS service xii Evaluating the Potential of Container-Based Sanitation providers over the medium to long term. To keep sub- densifying services in existing areas of operation, sidies at the lowest level possible, CBS service providers opening up new areas of operation, and targeting new need to further reduce their costs, as they are already customer segments (for example, Sanergy targeted non- striving to do. resident landlords). Some CBS providers (particularly Clean Team and SOIL) have deliberately put customer To reduce costs per household, a certain scale and den- growth temporarily on hold in the past in order to focus sity of customers are needed, and the experience of the on improving the efficiency of their business models. CBS providers reviewed suggests that reaching such Customer growth can be subject to capacity constraints, a scale may take at least five years from the end of the such as toilet-manufacturing capacity (in the case of initial “start-up” phase.11 CBS works best when a high Sanergy); the capacity to attract, onboard, and provide proportion (density) of the population subscribes to the support to new customers (for SOIL); or regulatory service in a given area. This has implications for CBS’s constraints preventing the commercialization of reuse interaction with other viable sanitation alternatives products (for x-runner). where they exist as it would likely replace existing solu- tions only where the level of service provided is currently CBS approaches can play a key role as part of the CWIS very poor. Similarly, densification may be difficult where portfolio of solutions.12 CBS is a potential solution for other sanitation alternatives are already in place but do densely populated areas, particularly those where the not reach all households. Where applicable, planners environment for constructing OSS containment (that could identify “designated service areas” for CBS service is, latrines and septic tanks) and sewerage networks providers to foster densification and to scale up services, is ­challenging (due to lack of space, soil conditions, which is consistent with plans to roll out other non-CBS high-water tables, and/or topography), where access for sanitation services. emptying on-site solutions (for example, using v ­ acuum trucks) is limited, and/or where there is insufficient Growth has been steady but slow. Since launching, the water supply consumed by households to flush their four CBS service providers assessed for this report have toilet to a sewer. CBS approaches are also particularly achieved steady, though relatively slow, growth over suitable in flood-prone areas or in informal settle- time. Average customer growth rates range between 15 ments where  building a long-lasting, generally capital to 25 new toilet facilities installed per month, with the cost-intensive ­infrastructure—such as a latrine—may be largest general number of new customer installations difficult due to land tenure issues or physical conditions observed in all four cases around 40 units per month. (for example, where there are settlements on stilts above Exceptions include months when as many as 75 new water bodies). customers signed up for SOIL and 65 for Sanergy (where each toilet serves an average of 35 to 40 people). Over- For the CBS service providers reviewed, the study all, the CBS service providers assessed have experienced found that they provide a sanitation solution that is surges in growth, but they have also had brief periods of viewed by existing customers as superior—in terms of toilet closures/withdrawals by customers who had accu- hygiene, comfort, and convenience—to existing alterna- mulating debts or who had failed to operate their toilets tives, mainly due to the service providers’ strong focus hygienically. on ­customer service and the poor quality of existing sanitation services. In existing CBS service areas, the ­ arious CBS service providers have experimented with v alternative sanitation solutions are generally unhy- strategies to drive growth in their customer base, gienic pit latrines and/or limited numbers of public including changing sales approaches, reducing prices, toilets, which may not be adequately constructed or run. Evaluating the Potential of Container-Based Sanitation xiii Pit latrines in Port-au-Prince, Cap-Haitien, and Nairobi to be reached by other solutions in the short term as are considered expensive to desludge, so the process is they are less infrastructure-intensive and can provide often delayed and when the rainy season arrives, they improved sanitation services while the government frequently overflow. When desludging is conducted, it decides whether to explore or roll out other sanitation is done manually and the sludge is often disposed of approaches. However, it appears that in the majority of unsafely into the nearby environment. cases, these services are not yet ready to be significantly scaled up, as many of the existing providers have been Pour-flush public toilets in informal settlements in and focusing on increasing service density in their existing around Mukuru, Nairobi, are few in number and con- service areas before looking to expand.13 centrated at the periphery of the settlements, which also makes them unsafe to use at night, especially for women In most areas where CBS is currently being imple- and girls. In the low-income peri-urban settlements mented, municipal authorities and/or utilities have on the hill slopes around Lima, households gener- plans for rolling out alternative solutions at scale, such as ally have their own pit latrines, but once these fill up, sewer-based sanitation. Physical and financial barriers, the limited plot sizes, steep slopes, and, in some areas, however, imply that investment-heavy solutions may not hard rock subsoils make it difficult and costly to build be forthcoming at scale in the foreseeable future. In such a new latrine. In Kumasi, Ghana, public toilets have situations, CBS can be seen as a practical and robust long been a widely used sanitation option and remain ­solution to be considered as part of the sanitation options the main alternative to CBS, despite local authorities’ portfolio to deliver universal sanitation. In reality, in strategy to promote a toilet in every household, one that many cases, it would take years, if not decades, before appears to be hampered by design standards that result sewers are rolled out to all households in some of the in expensive toilets. Furthermore, the public toilets are most rapidly expanding cities of developing c ­ ountries. not always well-maintained and are not conveniently CBS services could, therefore, be adopted in the interim located for many households. CBS may also be preferred period while more durable solutions that can tackle all to sewer-based sanitation in situations where there is excreta streams are designed and gradually rolled out. insufficient water supplied to the households to allow They are also suitable for situations where the duration the sewers to function. of stay or permanence of a community is unclear, such as in refugee camps—Sanivation has successfully deployed CBS service provision is labor-intensive and, therefore, this kind of service in Kenya.14 may be more cost-effective in areas where low-skilled labor is cheap and the corresponding running costs are lower than the amortized cost of the construction Emerging Lessons of on-site structures and the mechanical equipment needed to service them (for example, exhauster trucks The review of the four CBS case studies has generated for collection/transportation of feces). emerging lessons for governments and external funders that may be considering supporting CBS technologies The advantages and potential drawbacks of CBS and services development. approaches are summarized in table ES.1. There are sev- eral advantages, particularly in terms of inclusiveness CBS approaches should be considered as part of a and resilience, that make these services a good consid- menu of CWIS options. The specific planning and roll- eration as a service delivery approach within a menu of out of CBS services would vary based on location, but, CWIS options. In some cases, CBS approaches can also as with other CWIS solutions, it should be articulated provide a “stopgap” measure in areas that are unlikely priorities. closely with urban planning and development ­ xiv Evaluating the Potential of Container-Based Sanitation Table ES.1 • Summary of Potential Advantages and Limitations of CBS Services Potential advantages Potential limitations ·· Inclusive: CBS is a practical approach ·· Current dependence on external funding: CBS service in hard-to-reach areas, where space is providers rely on external funding to cover 80 to 90 constrained, it is difficult to dig, or the percent of their costs. Such reliance would likely reduce water table is high. Where CBS toilets are as service density increases and economies of scale are in-house, it can improve safety for women realized. and girls. ·· Dependence on external expertise: CBS service models ·· Resilient: CBS is a good solution both in were set up by entrepreneurs who are non-native to the water-scarce areas (such as Nairobi or countries of operation. The staff working for these providers Lima), as it is associated with lower water all appear highly committed to the operations, even if quite consumption, and in areas with risk of dependent on the ongoing involvement of their founders. flooding (such as Haiti). ·· Relatively slow growth rate: Despite having been in ·· Sustainable: Emphasis is on the whole operation for more than five years, most CBS service service chain, either via services provided providers are still at a relatively early stage of development directly by the CBS service provider or in and are still working out their business models. In some partnership with others. cases, they have temporarily curtailed expansion while they ·· Acceptable to customers: Most customers work on improving their operating margins. Existing CBS express overall satisfaction with existing service providers that have been reviewed indicated they CBS services. are not ready to scale up beyond their current areas of operation. ·· Hygienically safe: CBS is safe as long as proper handling, treatment, and reuse ·· Lack of explicit regulation and service standards: In some of the feces along the service chain is cases, a legal vacuum can limit the types of services that maintained. CBS service providers can offer. ·· Affordable: CBS does not require upfront ·· Partial solution: Complementary approaches are needed investments for the households, who have for greywater management. As urine is heavy to transport, to pay only a periodic (daily, weekly, or none of the CBS service providers currently process and monthly) fee. reuse it (with the exception of Loowatt), which has potential ·· Efficient: Most CBS service providers impact on the environment in areas where the water table have a business approach, with heavy is high. focus on improving the efficiency of their ·· Limited interaction with local authorities: Some CBS services operations and with good awareness of were developed independently to fill sanitation service gaps, their costs: They are generally working with limited interaction with mandated service providers to generate further efficiency gains and and/or local authorities. They have increasingly worked on reduce costs, which should reduce the developing relationships with local authorities, however, so need for external subsidies over time. this issue has been reduced over time. Evaluating the Potential of Container-Based Sanitation xv One option could be to identify geographical areas well-suited as the CBS units are rapidly movable and where CBS approaches would be the most appropriate can be deployed—and redeployed—quickly to meet or the best fit, given local conditions, and support their unplanned influxes of people. development accordingly. Adopting a conducive policy and regulatory envi- The introduction of CBS services could be considered ronment could be an important first step for especially for poor urban populations for whom alter- governments looking to foster CBS services in suit- native on-site or sewer-based sanitation services might able areas. Regulation of CBS and FSM services would not be appropriate. These include dense slums and areas ideally be done in conjunction in order to regulate pub- that are flood-prone or hard to reach (such as hilly ter- lic health and environmental aspects up to the point rains or settlements above or very near to water courses). where the pathogen and nutrient parameters meet the CBS services can also be considered for areas where: national/local standards for discharge to a water body, disposal to a landfill, or transformation into a reuse • The housing density and/or the size of the living product. This would include clear procedures for oper- quarters prevent the construction of pits or septic ators in the emptying and transportation processes to tanks or the laying of sewers and where most of the ensure that all CBS and FSM service providers are held population lives far (that is, more than 50 meters) to the same standards in mitigating potential health from existing shared toilets, which means that and pollution risks. Regulatory oversight should also some people, notably women and girls, do not have ensure that CBS service providers adequately moni- safe access at night and disabled people might not tor the operation and management of CBS toilets by have access at all;15 customers and react swiftly and appropriately where • The ground conditions are not suitable for the hygiene is substandard. installation of latrine pits, septic tanks, or sewers (for example, flood plains); Where it does not exist, a regulatory framework should be developed for the reuse of treated feces/excreta, • Landlords are not willing to invest in toilets; including for agricultural and other uses, which have • Water shortages make sewer-based solutions more sometimes been limited by health concerns—such regu- challenging; lation would serve for both CBS and other FSM services. • The majority of households do not lie on roads The development of overall service standards could or paths that are large enough or otherwise suit- enable broader replication of CBS service models and able for the installation of sewers (including benchmarking of service quality, thus promoting con- narrow diameter sewers, though these simplified/­ sistency and further confidence in the CBS approach. It can be installed in very dense slums with minimal would also provide a level playing field to allow for the access  ways) or are not accessible for proper FSM development of CBS approaches alongside other sanita- access and collection; or tion services, especially OSS and FSM. A better definition • Existing sanitation planning does not foresee the of the institutional framework required for developing rollout of more conventional sanitation services in and monitoring standards could help improve the safety the short to medium term. of services and overall service quality. Some CBS service providers (such as Sanivation Recognizing that CBS service providers will likely not in Kenya) have also started expanding in refugee be covering their full costs in the short term—and that camps, where such approaches can be particularly most urban sanitation services are subsidized—public xvi Evaluating the Potential of Container-Based Sanitation authorities and/or water supply and sanitation (WSS) • How can CBS services be integrated within a service providers could explore ways to ensure that broader menu of options for WSS and CWIS ser- CBS services are sustainably financed. Examples vice provision so as to facilitate service integration, include cross-subsidies from services provided in more promote services to the poor, and encourage cost affluent service areas, including other types of sanitation recovery? provision and other related services (for example, water • What management models can be considered to supply or solid waste management) or direct subsidies ensure the safe provision of CBS services, ranging from public sources. In situations where governments from dedicated CBS service providers to the incor- contract CBS service providers for delivery in spe- poration of CBS as part of a menu of options pro- cific areas, such arrangements could be structured as vided by larger utilities? performance-based contracts so as to introduce incen- • How do CBS approaches compare financially and tives for greater efficiency, cost reductions, and greater economically to other available sanitation alterna- accountability. tives in the cities where CBS service providers cur- rently operate or could potentially enter? The customer-oriented nature of CBS services means that the providers offer a way for new customers to begin • How can existing CBS service providers be sup- accepting to pay for sanitation services and to practice ported to scale up service provision in existing better household hygiene which, in turn, is more widely service areas or to expand into new areas, where beneficial. As and when other sanitation solutions are applicable? rolled out in the future, forerunner CBS services can • How could performance-based contracts be fill more than a temporary access gap as they also build designed for CBS services? What could be suitable the mindsets of customers who subsequently value san- service standards and “payment triggers” as a part itation services and who are used to interacting in a of results-based financing arrangements? responsible way with service providers. Notes Areas for Further Analysis   1 For the purpose of this report and in alignment with the CWIS approach, the sanitation service chain consists in containment, Although this report indicates that CBS can effectively emptying/collection, transport, and treatment and reuse/disposal. provide safely managed sanitation in urban areas, there In addition, activities related to demand creation and marketing have been considered in their own right as part of the sanitation are currently a small number of operators providing CBS value chain, given their importance for CBS services. services in different parts of the world, each at a rela-   2 In this report, the term excreta is used instead of waste to avoid any potential confusion with solid waste. Tilley et al. (2014) define tively limited scale. As these existing CBS operators scale excreta as “urine and feces that is not mixed with any flushwater.” Note that for the four CBS case studies prepared for this report, the up their services, it will be important to continue car- feces and urine are separated using urine-diverting toilet technol- rying out operational research to explore the following ogies. Cases where the CBS service provider collects only feces are referred to accordingly as feces. Also note that cover material (for questions, among others: example, sawdust or carbon cover) is added to the feces or excreta in all cases.  • What constitutes a safe CBS service, and what are   3 It is worth noting that other sanitation solutions may respond to some of these challenges. For example, condominial sewers and its essential features? Can a broadly accepted defini- other forms of simplified sewerage have proved to overcome a tion of “safe CBS services” be developed to provide number of these challenges, whereas dry sanitation can be appli- cable for situations with low water supply. However, CBS has been the basis for their inclusion as part of the improved identified as one of the options that responds to all these chal- lenges simultaneously. sanitation options for achieving sustainable devel-  4 For example, Sanitation First in India, Banza in Nairobi, and opment goal (SDG) 6?16 the nongovernmental organization (NGO) Maji Safi kwa Afya Evaluating the Potential of Container-Based Sanitation xvii Bora Ifakara (Safe Water for Better Health Ifakara; MSABI) in not be sufficient to deliver CWIS services for all. CWIS occurs Tanzania. where everybody benefits from adequate sanitation service   5 Current members of the CBS Alliance include SOIL, Sanergy, delivery outcomes; fecal waste is safely managed along the whole Clean Team, x-runner, Sanivation, and Loowatt. sanitation service chain; effective resource recovery and reuse are considered; a diversity of technical solutions is embraced   6 Loowatt is currently the only CBS service provider that does not for adaptive, mixed, and incremental approaches; and on-site separate urine from feces. A waterless flush helps to seal urine and and sewerage solutions are combined, in either centralized or feces in biodegradable polymer film in a plastic container, which, decentralized systems, to better respond to the realities found in once full, is collected and hand-delivered to Loowatt’s treatment developing country cities. ­ plant. There, the waste is anaerobically digested and pasteurized to produce liquid fertilizer and vermicompost. 13 Some of these advantages and limitations are shared with other sanitation service solutions. However, the focus of the report is not   7 Bucket latrines in emerging markets consist of open containers to compare CBS services with other sanitation services but rather used as toilets and serviced through regular emptying by bucket to assess CBS services in their own right. collectors. Although these were previously formal in urban areas of Ghana, they were declared illegal due to the unhygienic way in 14 This experience was not the subject of a dedicated case study for which they were used (there was no cover material or ­ separation the purpose of this report. of feces from urine) and in which excreta were collected, trans- 15 C.f. SDG 6.2: By 2030, achieve access to adequate and equitable ported, and disposed. The buckets were often not well-sealed, and sanitation and hygiene for all and end open defecation, paying the excreta was often disposed of into nearby gutters. Similarly, special attention to the needs of women and girls and those in these methods of excreta disposal were banned in Kampala, ­vulnerable situations. Uganda, and Kisumu, Kenya. For more detail, see S.  Tilmans, 16 In the SDG 6.2 definition and according to the Joint Monitoring K. Russel, R. Sklar, L. Page, S. Kramer, and J. Davis, 2015, Programme (JMP), “Improved sanitation facilities are those “Container-Based Sanitation:  Assessing Costs and Effectiveness designed to hygienically separate excreta from human contact.” of Excreta Management in Cap Haitien, Haiti,” Environment and (JMP 2018) Defining a safe CBS service could ensure that the Urbanization 27, no. 1: 89–104. solution is counted among those improved sanitation facilities in ­   8 Double-sealed means that the feces is contained in a plastic bag- SDG monitoring. lined bucket or a container with a lid. The only time when the feces is not double-sealed is when the plastic bag containing feces is removed from the bucket, either when transporting it manu- ally (in the case of x-runner) or when emptying the cartridges at the treatment location. In the case of x-runner, the plastic bag References is removed but is immediately put into a new bucket for manual transportation, where it is again double-sealed. Bill and Melinda Gates Foundation, Emory University, The University   9 CBS service providers have their own regular satisfaction surveys, of Leeds, WaterAid, Plan International, and the World Bank. 2017. which were consulted as part of the secondary sources reviewed. Citywide Inclusive Sanitation: A Call to Action. Details of the focus group discussions undertaken in each study location are included in the specific case studies. Joint Monitoring Programme (JMP). 2018. “Monitoring – Sanitation.” 10 This situation is representative of all CBS service providers, which World Health Organization and UNICEF. https://washdata.org​ are dependent on external financing to ensure their financial /­monitoring/sanitation viability. This aligns with the situation of other sanitation service ­ providers in developing countries, who are generally unable to Remington, C., M. Cherrak, N. Preneta, S. Kramer, and B. Mesa. cover the full-service costs from service fees and tend to rely on 2016. “A Social Business Model for the Provision of Household external subsidies. Ecological Sanitation Services in Urban Haiti.” Briefing Paper, WEDC Conference 2016, Kumasi, Ghana. 11 Although all the CBS service providers analyzed have been oper- ating for several years (in some cases, for more than five years), Sklar, R., and C. Faustin. 2017. Pit Latrines or Container-Based Toilets? this initial operational phase has provided time for the businesses A Cost–Benefit Analysis Comparing Two Approaches to Improving to start up so as to establish their service offerings and gain the Sanitation Access in Urban Areas of Haiti. Haiti Priorise: Copenhagen trust of policymakers and customers. As such, they haven’t been Consensus Center. focusing on densifying their service areas since day one, and they believe a period of five years from the moment they do start to Tilley, E., L. Ulrich, C. Lüthi, P. Reymond, and C. Zurbrügg. 2014. focus on this is required to achieve the necessary densification. Compendium of Sanitation Systems and Technologies. 2nd rev. ed. 12 The “traditional approach” to urban sanitation, premised on Duebendorf, Switzerland: Swiss Federal Institute of Aquatic Science extending sewerage networks and building WWT plants, will and Technology (Eawag). xviii Evaluating the Potential of Container-Based Sanitation A B B R E VIATIONS avg. average (mean) BSFL black soldier fly larvae CBS container-based sanitation CDC Centers for Disease Control and Prevention CWIS citywide inclusive sanitation DESA Dirección Ejecutiva de Salud Ambiental (Executive Directorate of Environmental Health), Peru DINEPA Direction Nationale de l´Eau Potable et de l´Assainissement (National Directorate of Water and Sanitation), Haiti EHSD Environmental Health and Sanitation Directorate, Ghana EIA environmental impact assessment EPS entidad prestadora de servicios de saneamiento (sanitation service provider), Peru FLO Fresh Life Operator FSM fecal sludge management GAMA Greater Accra Metropolitan Area HH household KeBS Kenya Bureau of Standards KESHP Kenya Environmental Sanitation and Hygiene Policy KMA Kumasi Metropolitan Assembly MOU memorandum of understanding MSABI Maji Safi kwa Afya Bora Ifakara (Safe Water for Better Health Ifakara), Tanzania NEMA National Environment Management Authority, Kenya NGO nongovernmental organization OREPA Office Régional d’Eau et d’Assainissement (Regional Water and Sanitation Office), Haiti OSS on-site sanitation OTASS Technical Organism for the Management of Sanitation Services SDG Sustainable Development Goal SEDAPAL Servicio de Alcantarillado y Agua Potable de Lima (Lima Sewerage and Water Supply Service), Peru SOIL Sustainable Organic Integrated Livelihoods SSP Sanitation Safety Plan SUNASS Superintendencia Nacional de Servicios de Saneamiento (National Superintendent of Sanitation Services), Peru t ton TP treatment plant UDDT urine-diverting dry toilet US$ United States dollar WASH water supply, sanitation, and hygiene Evaluating the Potential of Container-Based Sanitation xix WGP Water Global Practice (of the World Bank) WHO World Health Organization WSS water supply and sanitation WSUP Water & Sanitation for the Urban Poor WWT wastewater treatment xx Evaluating the Potential of Container-Based Sanitation INTRODU C TION The Urban Sanitation Challenge and resilient, and ensure citizens’ health and well-being. In this context, the World Bank Water Global Practice Urban population growth continuously outpaces (WGP) has identified urban sanitation as a significant gains in improved sanitation access and services. More challenge, as many cities in developing countries strug- than half of the world’s population is now urban, repre- gle to deal with the most basic task of managing fecal senting approximately 3.9 billion people, nearly 1 billion waste for all citizens. of whom live in urban slums with poor or no sanitation. The World Health Organization (WHO) and United “Business as usual” in urban sanitation is not working. Nations Children’s Fund (UNICEF) Joint Monitoring The “traditional approach” to urban s­ anitation—­premised Programme (JMP) estimates that 4.5 billion people in on extending conventional sewerage networks and build- the world do not currently have access to safely man- ing large, centralized wastewater treatment (WWT) aged sanitation. An estimated 57 percent of people living plants—will not be sufficient to deliver citywide inclusive in urban areas do not have toilets with a full sanitation sanitation (CWIS) services for all. CWIS occurs in situa- service, and 16 percent do not have a basic sanitation tions where everybody benefits from adequate sanitation service  (WHO and UNICEF 2017). Approximately service delivery outcomes; fecal waste is safely man- 100  million  people living in urban areas still practice aged along the whole sanitation service chain; effective open defecation. This results in environmental degra- resource recovery and reuse are considered; a diversity of dation; epidemic and endemic disease; low productiv- technical solutions is embraced for adaptive, mixed, and ity; and constraints on the delivery of essential urban incremental approaches; and on-site and sewerage solu- services such as housing, transport, potable water, and tions are combined, in either centralized or decentralized drainage. Ultimately, this limits economic growth, urban systems, to better respond to the realities found in devel- development, and city competitiveness. With limited oping country cities. financial and human resources, a changing climate, and rapid, unplanned urbanization, many cities are strug- Alternative approaches are needed to deliver adequate gling to cope. and inclusive sanitation services across the full san- itation service chain.1 Informal urban settings pose Improved sanitation results will generate multiple particular challenges in the rollout of sanitation ser- benefits, including lower disease burden, improved vices, such as difficult access; lack of land tenure or space nutrition, reduced stunting, improved quality of life, to build a sanitation solution; often challenging physi- ­iving increased attendance of girls at school, healthier l cal and topographical conditions, such as rocky soil, environments, better environmental stewardship, closeness to water bodies, and high-water tables; a lack increased job opportunities and wages, improved com- of water supply; and/or regular exposure to flooding. petitiveness of cities, and economic and social gains to Approaches are needed to meet these challenges so that society more broadly. The sustainable development goals the population living in informal settings, who are often (SDGs) provide a new impetus to ensure access to sus- among the most vulnerable, can benefit from adequate tainable water and sanitation services, keep cities safe sanitation services. Evaluating the Potential of Container-Based Sanitation 1 Cities need to develop comprehensive approaches cartridges) that are safely sealed and removed, without to sanitation improvements that encompass long- exposing residents or workers to the excreta, and taken term planning, technical innovation, institutional to a treatment or resource recovery center for process- reforms, and financial mobilization. They will need ing and cleaning. The service provider provides the to demonstrate political will and technical and man- customer with an empty, clean container when the full agerial leadership to focus on drivers for innovation one is removed. Transport methods can vary (and may and to  manage funding for sanitation in new and involve tuk tuks, motorcycles, hand carts, and donkey creative ways. carts) so as to adapt to a variety of space and logistical constraints. The present study was initiated to develop a better understanding of existing container-based sanitation CBS service providers may manage the entire sanita- (CBS) approaches and identify whether they could be tion service chain themselves or partner with other included as part of a portfolio of solutions for CWIS. groups or local authorities to implement other parts of the chain. Some of the CBS service providers build and operate resource recovery facilities, taking advan- What Are CBS Approaches? tage of the high nutrient content of the relatively “fresh” and undiluted excreta to produce biogas, solid fuel, Since the early 2010s, CBS models have emerged as an fertilizers, or other products. ­ alternative service approach in circumstances where existing sanitation solutions were deemed inadequate or unfeasible. CBS consists of an end-to-end service Report Objectives that collects excreta hygienically from toilets built with sealable, removable containers and strives to ensure that The objective of this report is to document and assess the excreta is safely treated, disposed of, and reused.2 existing CBS approaches, with a particular focus on Most CBS toilet systems separate urine from the feces evaluating their safety, reliability, affordability, and through urine diversion mechanisms, though none of financial viability. The report also seeks to identify the the CBS providers reviewed currently process the urine circumstances in which CBS approaches are most appro- for reuse, as it is heavier to transport. Households benefit priate and whether they could be considered as part of a from having a toilet in their own homes or nearby (with portfolio of options for CWIS. associated benefits of convenience and privacy) with- out having to provide upfront financing for investing in The study was motivated by the growing interest in infrastructure (such as a latrine), which in many cases the emerging CBS experiences and by the fact that they cannot afford. many governments, city authorities, and financing entities are often not familiar with the approach. Rather than building a sanitation facility, house- The study’s findings should be relevant to public sector holds (or public toilet operators) can sign up for a agencies (including governments, both at national and service. They are usually provided with a light, porta- local levels, water and sanitation service providers and ble toilet that is independent from any superstructure, other urban service providers, regulatory agencies, though in some  cases, such as for Sanergy, that can and others) and sector donors (including multilateral also be included. The CBS service provider conducts development banks, bilateral aid agencies, international regular visits to empty the facilities. The toilets con- nongovernmental organizations (NGOs), and founda- tain sealable excreta containers (also referred to as tions) that may wish to better understand these models 2 Evaluating the Potential of Container-Based Sanitation and consider them in the design of urban sanitation pro- study was prepared as a stand-alone report using a grams. The study could also be relevant for CBS service ­common format. providers looking to improve performance and scale up operations. The case studies include interviews with key personnel of each CBS service provider; the collection of docu- ments, data, and reports; and observations of equipment, Study Methodology facilities, and key activities. Interviews were held with customers and users, investigating their motivations for The study was conducted in three stages: adopting the service, their level of satisfaction, com- plaints, and the sanitation alternatives available to them • Stage 1 – A global landscaping study as well as their reasons for not using them. Local residents • Stage 2 – In-depth case studies of selected CBS not currently using CBS services were also interviewed. models Officials from the relevant policymaking and regulatory • Stage 3 – A summary assessment (this report) bodies and utilities were interviewed to ascertain their knowledge and views of CBS, if and how it is regulated, Stage 1 involved a global mapping of where CBS and what future plans exist that might impact the pros- approaches have been introduced and a rapid review pects of CBS in the city in question. A summary is given of their performance based on readily available in table I.1. information. This phase included gathering informa- tion from CBS entrepreneurs and from organizations Views from a limited number of service users were gath- that have financially supported such approaches or are ered through individual interviews and focus group considering doing so in the future. Information was discussions. No representative surveys were undertaken collected regarding their perceptions on the quality ­ for the purpose of the study due to time and budgetary of CBS services, their relevance for developing country constraints; however, where the CBS service providers contexts, and their assessment of the viability of current had themselves conducted surveys, this information was CBS models and prospects for expansion. consulted. Details and a full list of references are pro- vided as appendixes to the case studies and Appendix A Based on this global mapping, representative case stud- of this report. ies were selected for further analysis. The criteria for selection were to include CBS service providers that Stage 3 drew a summary assessment on the affordabil- were already operating at a comparatively larger scale ity, safety, reliability, and financial viability of existing while ensuring a diversity of operating models. CBS approaches. On the basis of this analysis, prelim- inary conclusions were formulated as to whether CBS Stage 2 consisted of four in-depth case studies of CBS approaches could be adopted as part of a mix of sanita- service providers identified under Stage 1, namely tion solutions to promote CWIS. Sanergy (Kenya), Sustainable Organic Integrated Livelihoods (SOIL) (Haiti), Clean Team (Ghana), This report builds on the main findings from the case and x-runner (Peru). Each study investigated how CBS studies. It formulates lessons from these experiences services fit within the overall city context and assessed aimed at governments, funders, and other stakehold- how each provider compared with alternative sanitation ers who may be interested in incorporating CBS into ­solutions, from the point of view of customers and of the a portfolio of sanitation solutions to deliver universal authorities responsible for sanitation services. Each case services. Evaluating the Potential of Container-Based Sanitation 3 Table I.1 • Information Collected from Stakeholders for the Case Studies Overall city context ·· Economic and political environment, poverty characteristics ·· Water and sanitation service coverage, including hardware and service coverage across the whole sanitation service chain, FSM, and septage management ·· Areas served by alternative sanitation options—common characteristics/subdivisions (socioeconomic profile of population) ·· Current and planned target areas for CBS service provider being studied ·· Topography, water availability/scarcity indicators, housing density, physical and communication infrastructure, labor market (skills, cost of labor) Key stakeholders and topics for study Authorities/utilities Community leaders ·· Policies (national/municipal) ·· Public perceptions (CBS, alternatives) ·· Regulations (national/municipal) ·· Health impact ·· Enforcement ·· Environmental impact ·· Strategies and plans, including for meeting ·· Sanitation improvement plans, projects sanitation SDGs (if any) ·· Potential for expansion of CBS ·· Key metrics when evaluating CBS ·· Local political considerations and their impact ·· Current support for CBS (funds, land, etc.) ·· Potential and future support for CBS CBS service provider and commercial partners Customers and other local residents ·· Operations mapping ·· Motivation/concerns for adoption ·· Sales and marketing approach ·· Affordability ·· Cost recovery ·· Perception of CBS versus alternatives ·· Challenges ·· Satisfaction/complaints ·· Partnerships/tensions ·· Consistency of use of service ·· Health/environmental impact evaluation ·· Turnover/dropout reasons ·· Plans for expansion and support required Donors/financiers Financing to date (amount, type) Anticipated returns and timeline (social, financial, and environmental) Future support plans Note: CBS = container-based sanitation; FSM = fecal sludge management; SDG = Sustainable Development Goal. 4 Evaluating the Potential of Container-Based Sanitation Notes References 1 For the purpose of this report and in alignment with the CWIS Tilley, E., L. Ulrich, C. Lüthi, P. Reymond, and C. Zurbrügg. 2014. approach, the sanitation service chain consists of containment, Compendium of Sanitation Systems and Technologies. 2nd rev. ed. emptying/collection, transport, and treatment and reuse/disposal. Duebendorf, Switzerland: Swiss Federal Institute of Aquatic Science In addition, activities related to demand creation and marketing and Technology (Eawag). have been considered in their own right as part of the sanitation value chain, given their importance for CBS services. World Health Organization (WHO) and United Nations Children’s 2 In this report, the term excreta is used instead of waste to avoid Fund (UNICEF). 2017. Progress on Drinking Water, Sanitation, and any potential confusion with solid waste. Tilley et al. (2014) define Hygiene: 2017 Update and SDG Baselines. JMP (Joint Monitoring excreta as “urine and feces that is not mixed with any flushwater.” Programme). Geneva: World Health Organization and the United Note that for the four CBS case studies prepared for this report, Nations Children’s Fund. the feces and urine are separated using urine-diverting toilet tech- nologies. Cases where the CBS service provider collects only feces are  referred to accordingly as feces. Also note that cover material (for  example, sawdust or carbon cover) is added to the feces or excreta in all cases.  Evaluating the Potential of Container-Based Sanitation 5 C HA P T E R 1 • OV E RVIE W OF C B S S E RVI CE M OD E LS A Short History of CBS for-profit start-up, first established a full sanitation chain approach in Naivasha to serve households. Since then, Container-based sanitation (CBS) approaches first it has implemented CBS services in a refugee camp and emerged when different actors sought to design safe signed a memorandum of understanding (MOU) with sanitation solutions for the urban poor with the the water and sanitation utility in Naivasha and the local potential to overcome four critical obstacles: government to process all the fecal sludge in the county. • Severe physical space constraints for installing and Others focused, at least initially, on one or the other end emptying on-site sanitation (OSS) solutions, com- of the sanitation service chain. x-runner in Peru began bined with the high risk of flooding of these solu- with industrial designers seeking a mobile toilet solution tions in some areas; that would deal with space constraints and poor access • The high cost and technical challenges associated to emptying services. Loowatt focused on developing a with installing conventional sewerage networks in waterless toilet that facilitates excreta reuse. Clean Team dense and informal urban areas; was set up to test the idea that a containment, emptying, • Low political priority of sanitation for the urban and transport service could be set up as a business—in a poor, leading to low investment; and context where people were already paying for public toilets. • Poor and unreliable availability of water. These CBS pioneers, which are also the largest service Implementation of CBS approaches on the ground providers at this point in time, came together in late started in the early 2010s. In 2009, Sustainable Organic 2016 to form the CBS Alliance, as described in box 1.1. Integrated Livelihoods (SOIL) and Oxfam launched a Manila Water, a private company, is testing the appli- household CBS project in northern Haiti before shifting cability of CBS as an alternative front-end component focus to CBS as an emergency response to the earthquake for areas where other sanitation alternatives, such as in Haiti’s capital in 2010. Sanergy launched operations in ­sewer-based solutions or septic tanks, cannot be installed Kenya in 2010; promptly followed in 2011 by SOIL in Haiti due to space or other topographical constraints. Manila (when it relaunched its CBS household service), Clean Water provides water and sewerage services in the Manila Team in Ghana, and x-runner in Peru; then Sanivation in Metro East area under a 25-year concession contract and Kenya in 2012; and finally Loowatt in Madagascar in 2014. is looking for solutions for the customers at the bottom Some pioneer CBS service providers began with a full of the pyramid. Following a presentation of Clean Team’s sanitation service chain approach. Sanergy began as a for- early experience in 2014, Manila Water decided to carry profit start-up whose business model was to link the safe out a CBS pilot in the service area of Laguna Water, one sanitation service chain with agricultural markets. SOIL’s of its subsidiaries that provides water services to approx- operation evolved from a EcoSan public toilet model, imately 80 percent of households in the municipalities of which had been implemented in rural and urban areas of Biñan, Santa Rosa, and Cabuyao in the Laguna Province. Haiti since 2006. SOIL started with public double-vault An initial phase of the pilot took place in 2017, during composting toilets before moving to container-based which two alternative toilet models were tested from Lixil household toilets as the challenges of voluntary man- and Loowatt in 30 households. The pilot’s objective was to agement of toilets became apparent. Sanivation, another identify whether this approach could be scaled up in areas 6 Evaluating the Potential of Container-Based Sanitation Box 1.1 • The CBS Alliance The CBS Alliance is a coalition of container-based sanitation (CBS) practitioners from around the world. The founding members of the CBS Alliance include Sustainable Organic Integrated Livelihoods (SOIL), Sanergy, Clean Team, x-runner, Sanivation, and Loowatt. Members came together in November 2016 to promote knowledge sharing and learning, to create a set of common CBS guidelines and standards, thus formalizing CBS as a service model, and to provide the basis for a scale-up of these services beyond its initial members. See www.cbsa.global for more information. that are difficult to reach with more conventional sanita- and were not investigated in detail as part of this study, tion solutions or where space is limited so as to comply in some cases because they function more like conven- with Laguna Water’s universal service obligations. The tional NGOs rather than companies seeking to adopt an pilot also aimed to compare the two portable toilet mod- entrepreneurial approach. Sanitation First has a multiple els according to specific criteria (financial, environmental, container system with four containers on a roller base customer satisfaction, health and safety, and ability to underneath toilet floors, which works so that the feces are scale up) and rank them accordingly. The pilot is embed- older and drier by the time they are removed. Its system ded in Laguna Water’s “Utility Business Model,” wherein serves 10 to 12 neighboring households in Puducherry water revenues cross-subsidize the operations and main- and Cuddalore in India. Fondación Sumaj Huasi (La Paz, tenance of its “used water services” after the collection of Bolivia) has constructed more than 900 high-standard environmental fees (2018). The Laguna Water team has household EcoSan toilets that use a 100-liter movable presented pilot results to Manila Water’s management and container to store the feces, which is collected monthly, is exploring the potential for further rollout. and 20-liter jerrycans to collect the urine, which is col- lected weekly. Initially, households were encouraged to The aforementioned CBS service providers have use the excreta in their own gardens, but later, two local different legal arrangements, but all are seeking a companies initiated a collection service. The feces are self-sustaining business model. Manila Water, Loowatt, treated via vermicomposting, and the urine is stored for and Sanivation are private companies, though they have three months and then used as fertilizer (Suntura and received funding from philanthropic foundations. SOIL Sandoval 2012). Banza portable toilets were piloted in is a U.S.-based nonprofit organization, and Clean Team Mathare, an informal settlement in Nairobi, in which is a Ghana-based social enterprise set up by a partnership compostable bags held the feces, which was collected between a U.K.-based nongovernmental organization daily. A business model was to be developed but, as of (NGO), a large private corporation, and an academic 2017, the operation appeared to have stopped. The NGO research organization. Sanergy is composed of two enti- Maji Safi kwa Afya Bora Ifakara (Safe Water for Better ties: a for-profit entity, which provides services at a fair Health Ifakara; MSABI), in Tanzania, developed a seal- market value to its nonprofit entity (which owns a toilet able polyethylene tank designed to be emptied monthly. franchise) while selling reuse products with an eye to gen- This is a pilot nonprofit operation with no associated erating profits. x-runner is a private Swiss company, whose business model. operations in Peru are conducted by a Peruvian nonprofit. Key characteristics of the CBS service providers identi- Four other examples of sanitation solutions that fit fied through the study are summarized in table 1.1, for the CBS Alliance’s definition of CBS were also iden- those service providers where information was avail- tified. These approaches are not yet fully developed able. The remainder of this report presents information Evaluating the Potential of Container-Based Sanitation 7 Table 1.1 • Key Features of CBS Service Providers (as of May 2017) 8 Clean Manila Sanitation Sanergy SOIL x-runner Sanivation Loowatt Sumaj Huasi Team Water First Corporate Dual: nonprofit Nonprofit Nonprofit Dual: For-profit For-profit Concession Nonprofit Nonprofit Evaluating the Potential of Container-Based Sanitation status and for-profit nonprofit utility and for-profit Location Nairobi, Kumasi, Cap-Haitien Lima, Naivasha, Kakuma, Antananarivo, Laguna El Alto, Bolivia Puducherry and Kenya Ghana and ­Port-au- Peru Kenya Kenya Madagascar province Cuddalore, Prince, Haiti India Type of srea Dense urban Dense Dense urban Peri-urban Peri-urban Refugee Dense urban Dense Peri-urban Dense urban urban camp urban CBS start date 2010 2011 2009 2011 2012 2016  2014 2017 1998 2014 Toilets in 1,026 1,100 1,049 739 120 250 100 30 (pilot) 900 92 operation Population 47,746 uses 5,500 6,295 served 3,695 600 1,250 500 served 100 served  No data  No data  served or uses per day served served served served per day Access Shared/ HH HH HH HH HH HH HH HH Group of compound/ compound 10 HH school Cost of toilet US$345 US$92 US$27 US$115 US$46 US$187 US$200 TBD US$770 No data unit to service (ferrocement) or provider US$50 (wood) Containment Fixed squat Portable Portable Portable Portable Fixed Portable TBD Fixed Fixed squat seated seated seated seated seated seated seated Cover material Sawdust Sawdust Agricultural Sawdust Ash Charcoal Biodegradable TBD Sawdust; small Ash waste dust bag amount of water after urinating Urine-diverting? Yes Yes Yes Yes Yes Yes No TBD Yes Yes Collections/ 76% daily One One or two One Two Two One Two Monthly One week 23% every two (mostly) or three days User payment Pay per use Monthly Monthly Monthly Monthly Free Monthly Water bill Monthly Free Feces/month 165 137 46 20 8 7.5 4 (feces + Negligible Not known  Not known  collected (t) urine) (pilot) Main reuse Compost, None Compost Compost Solid fuel briquettes Electricity, None Compost Compost products animal feed  fertilizer Note: HH = household; t = ton. related to the four case studies that were analyzed in • CBS approaches can also be extended in emer- more detail. gency situations or in refugee camps, where they can be deployed rapidly without the need for build- ing permanent infrastructure. Where Have CBS Approaches Been Developed? Some potential customers living in single-room dwell- The main target markets for CBS are the urban poor ings, however, have insufficient space and privacy to living in densely packed settlements. CBS approaches install a CBS unit.1 As most potential customers in its offer several advantages for this market: service area face such circumstances, Sanergy provides • CBS requires less space than other solutions shared toilets, with different arrangements for public/ such as traditional OSS or sewers, which normally commercial areas, compounds of multiple dwellings/ require stand-alone superstructures (large pits or households, and schools. vaults/tanks as well as ways to access and empty them) in compounds/yards or space within house- CBS Service Models across the Sanitation holds for their installation. Service Chain • Household CBS toilets can be moved or rein- stalled if the subscriber moves. There are, there- The majority of CBS approaches seeks to provide fore, no sunk costs for the customer and limited services across the entire service chain, though each sunk costs for the service provider. provider delivers different levels of service. For the • CBS toilets can be more climate-resilient than purpose of this report, the sanitation service chain is alternatives and safer than badly run on-site solu- broken down into six steps: tions, as the feces is sealed in the container and • Demand creation: Promoting safe sanitation prac- does not leak into the environment. In areas that tices and the uptake of related suitable hardware are prone to flooding, for example, due to the lack and products of urban drainage, CBS toilets can provide a more hygienic solution than on-site solutions as the latter • Containment: The toilet unit where excreta is ini- tend to overflow and/or infiltrate into the ground- tially contained water. CBS toilets are also more climate-resilient • Emptying: Removing the excreta from the toilet’s in areas with scarce water resources as they do not storage system necessitate water and alternative products, such as • Transport: Moving the excreta from the emptying sawdust, are used as cover. Sewers require a mini- point to the treatment site mal use of water for proper flushing. • Treatment: Bringing the levels of pathogens and • CBS requires no upfront investments by users nutrients in the excreta to safe/permitted levels for (or landlords) because they require limited or no disposal/reuse in-house construction; thus, there is no need to • Disposal/reuse: Discharging the treated excreta to invest in building infrastructure. This makes CBS the environment or incorporating it into, and sell- particularly attractive to renters, who may face ing, a reuse product difficulties obtaining a toilet from their landlords. Payments for the service are spread over time (typ- Figure 1.1 shows which segments of the sanitation ically a monthly fee) and can, therefore, be more service chain selected CBS service providers cover and affordable for cash-strapped households. illustrates that the customer (or franchisee in the case of Evaluating the Potential of Container-Based Sanitation 9 Figure 1.1 • C  BS Service Providers along the Sanitation Service Chain vs. Conventional Sanitation Service Providers Primary Secondary Containment Emptying Treatment Product transport transport Compost animal Sanergy Franchisee Sanergy feed Solid fuel Sanivation Customer Sanivation briquettes SOIL Customer SOIL Compost CBS service providers x-runner Customer x-runner Compost Municipality Clean Team Customer Clean Team (KMA) Manila Water Customer TBD Manila Water Electricity, Loowatt, utility, Loowatt Customer Loowatt hotwater, NGOs, companies compost Conventional Sewer-based Customer Municipal utility OSS and FSM Customer Desludging contractor Municipal utility Note: KMA = Kumasi Metropolitan Assembly; NGO = nongovernmental organization. Dotted line indicates the position of the boundary between the house (or of the public toilet in the case of Sanergy) and the external areas where other sanitation services are provided. Green bars show the scope of the CBS service. Red bars show customer responsibilities (except in the case of Sanergy, where a franchised operator (green bar) manages containment). Purple bars show utilities’ areas of responsibility. The gray bar shows services contracted to a third party. Reuse products are shown on the right-hand side for additional information. Sanergy), the CBS service provider, and the municipal- not pay or does not operate it in a hygienic manner. For ity/local authority play different roles. This is compared example, x-runner uninstalls toilets if its staff does not with typical setups for more conventional alternatives, observe adequate standards of hygiene at the household including sewer-based solutions and OSS with fecal level and if users do not respond to hygiene promotion sludge management (FSM).2 visits and adjust their behavior accordingly. In the case of Sanergy, if adequate standards are not met (namely CBS service providers have made different choices on the toilet is not kept clean and adequate consumables are which segment of the sanitation service chain to tackle, not provided), the contract with the franchised opera- maintaining tight control over containment, emptying, tor can be cancelled. Sanergy would then repossess the and transport. Although the customer operates the toi- squatting plate and the containers (the toilet superstruc- let, the toilet remains the property of the CBS service tures themselves are not portable) and debrand the toilet provider, who could repossess it if the customer does superstructure. 10 Evaluating the Potential of Container-Based Sanitation Figure 1.2 •  Summary Description of Four CBS Service Providers along the Sanitation Service Chain (as of April–May 2017) Service Demand End use/ Containment Emptying Transport Treatment chain creation disposal Wooden or Bucket collected ferrocement portable on the doorstep Composting using Compost produced Customer referrals UDDT with Western- Flatbed truck bin systems in Collected with and sold to to transport from Cap-Haitien, and community style toilet seat, wheelbarrows April 2017 organizations and events both locally made transfer sites to individuals Haiti SOIL and three-wheeled Capacity to treat treatment site 20-liter feces and transporters 68 t feces/month Production: Door-to-door Truck capacity: 3-liter urine containers Avg. 340 toilets 7.6 t/month in sales 500 buckets 46.5 t treated in 849 units in emptied/day May 2017 April 2017 April 2017 Feces: 2 t/day 1,026 urine-diverting 20 handcarts Composting in Waste containers Compost sold as public toilets, with Four wheelbarrows windrows: Multiple swapped with Evergrow brand: molded plastic Two three-wheel approaches due Cold-call sales visits clean ones. Feces Production of squat plates Nairobi, Kenya transport to co-waste 10 to 80 t/month in current areas container is lined 11 collection availability Sanergy of operation 45-liter feces and with a plastic bag and total sales of 2-liter urine containers centers 550 t between Reusable canvas Animal feed Referrals Two 7-t trucks March 2016 and Concrete superstructure bags tried production using One 3-t truck June 2017 Credit via Kiva Bank BSFL Avg. 47,746 Feces: 5.5 t/day One transfer station (consolidation into Urine disposed Animal feed sold as uses/day Urine: 5.5 t/day 160-liter drums) of in sewers Pure Protein brand in May 2017 Evaluating the Potential of Container-Based Sanitation Door-to-door sales Plastic, seated Avg. 380 UDDT portable toilet Microsite, cartridges Kumasi, Ghana Community events one transfer site Clean Team outside mosques 20-liter feces container collected within Non-engineered on Fridays (avg. five users for the customers’ Four three-wheeled drying beds at Landfill four days) houses/day transporters municipal Monthly community One tractor treatment site events to showcase Urine to small Collectors use Two trailers service soakaway tuk tuks Separett-brand UDDT Users remove plastic Composting using portable toilets bags of feces, One four-wheel Probac effective Compost produced Door-to-door sales (737 in May 2017) carry them in drive, 7-t truck microorganisms (12 t in April 2017) Lima, Peru separate bucket Small quantities sold x-runner Currently increasing 23-liter feces container Neighborhood Three months in to the truck Added to sawdust focus on community lockers to store plastic bags Urine piped out to cover material meetings Avg. 122 toilets buckets of waste in (anaerobic) infiltration pit, (contains active emptied/day some areas latrine pit, or Two weeks in a microorganisms) container Feces: 1.2 t/day windrow Note: Avg. = average; BSFL = black soldier fly larvae; t = ton; UDDT = urine-diverting dry toilet. 11 A number of CBS service providers operate across the to minimize the potential for exposure and the risk to whole sanitation service chain, treating the feces for emptiers. ­ ­ However, the fact that the CBS service pro- reuse. The four service providers reviewed under the viders currently operate at a relatively small scale with case studies do so to a large extent, which is described a strong focus on safety and reuse has meant that they in more detail in figure 1.2. Clean Team is the exception, have been able to avoid illegal discharges. given that it only dries the sludge before disposing it to the municipal landfill. CBS services do not address all sanitation issues. For example, none of the existing CBS service providers Traditional approaches to sanitation service provision, tackle the issue of greywater management, which means including sewer-based solutions and OSS combined that alternative solutions need to be found for such waste with FSM, should successfully cover the full sanitation streams, such as connection to functioning drainage service chain when properly operated. In practice, how- pipes or to soakaways. ever, the more conventional services often fail to reach customers in the service areas where CBS service pro- The rest of this section presents how the CBS service viders are currently operating; WWT plants may not providers reviewed have organized service delivery safely treat all the sewage due to insufficient capacity, along the sanitation service chain. poor design, or improper operation; and sewage may enter the environment in significant quantities from Demand Creation and Marketing Strategies poorly operated or poorly maintained pumping stations or pipelines. Furthermore, OSS with FSM may carry CBS services currently involve substantial investment significant safety risks, notably at the points in the ser- of time and resources in customer onboarding and vice chain where feces is handled. The emptying of pits, support, primarily to deal with late payments and to vaults, septic tanks, and other OSS containment facili- maintain minimum standards of customer behavior. ties is often carried out by manual emptiers operating in unsafe conditions and/or the emptying is frequently The sales strategies the four CBS service provid- delayed too long by the households, resulting in the ers employ are similar, but the organization of their overflowing of fecal sludge into the environment, partic- sales teams is quite different. CBS providers typically ularly during heavy rains. adopt market-based strategies to gain new custom- ers, increase the density of their services, and reduce Additionally, the cost of desludging OSS facilities is one costs. These approaches include a focus on demand by of the reasons that the urban poor, who have fragile cash closely studying the needs of potential users, adapting flows, may be tempted to delay emptying. Desludging products to these needs, and ensuring that customer is often poorly regulated, and the business has gener- outreach and service personnel clearly communicate ally not been professionalized with standards, codes of with potential new customers. The sales strategies gen- conduct, and branded solutions. Therefore, there are erally revolve around door-to-door sales, promotions many situations with OSS and FSM in which the col- at community meetings and events, and incentivized lected excreta may be discharged—untreated—into the referrals by existing customers. The sales pitch is usually environment and in which the emptying process itself focused on the benefits of the toilet and of the service is unsafe for both workers and households. The associ- provided in terms of hygiene, convenience, and comfort ated lack of regulation/oversight could also potentially and on the unpleasant, unhygienic, and inconvenient affect CBS service providers, even though the customer-­ nature of existing sanitation alternatives. Referrals by oriented nature of the services and the design of the existing customers are an important component of mar- containers, which are not vulnerable to flooding, aim keting strategies and ­support the approach of increasing 12 Evaluating the Potential of Container-Based Sanitation coverage density within the areas of operation in order thanks to the consequent increase in user density in a to further achieve economies of scale, and the CBS ser- given area. vice providers reviewed are specifically targeting slow CBS service providers have generally adopted a very adopters. responsive and customer-centric approach when it CBS service providers offer employees – and some- comes to nonpayment. The urban poor will often get times customers - financial incentives or rewards into debt, including with their CBS service providers, for successful referrals. SOIL currently does not have when financial difficulty strikes. CBS service providers dedicated sales staff and relies upon its collection ser- conduct follow-up visits with their debtors to under- vice personnel, who produce a little more than half of stand what the problems are and to see if and when the all new customer sign-ups. Clean Team’s and Sanergy’s customers can get back on track with their payments. sales team members, on the other hand, receive sub- Although most CBS service providers allow a grace stantial individual bonuses/commissions based on their period before imposing penalties or sanctions, in three number of sales. x-runner’s sales team has a team target, of the four case studies (that is, Clean Team, Sanergy, and team members follow up on each other’s sales visits, and SOIL), the service providers have uninstalled a sub- reflecting a strong team ethos within the organization. stantial number of toilets at some stage in their history to Another interesting aspect of x-runner’s strategy is that cut back on debtors, resulting in a corresponding signifi- it discounts the price of the service to all customers by cant and sharp dip in their customer numbers. 25 percent in communities that reach 50 percent or more CBS requires users to operate their facilities cor- coverage with its service. rectly, keeping them clean and using cover material in sufficient quantities. Poor utilization by households Sanergy has a franchise system in which toilets will generally be identified and reported by collection are operated as commercial public toilet ventures, agents, and follow-up visits will be made by customer by landlords for their (multiple) residents, or by support staff to reinforce the expected standards. Failure schools. This makes the sales and customer onboard- to respond to such follow-up orientation puts the safe ing process more complex. For the commercial toilets, sanitation chain at risk, particularly at the emptying/col- as well as some school toilets, negotiating access to lection stage. It also typically results in the uninstallation land requires Sanergy’s sales and government liaison of the toilet, which in all cases remains the property of team to coordinate with community leaders and local the CBS service provider. authorities. A  credit scheme for the installation pay- ments has been set up with Kiva Bank, a microlending Hygiene is also an important component of customer institution. Although Kiva shoulders the financial risk, interaction and service provision. All CBS service pro- Sanergy helps administer the system and is responsi- viders interviewed provide hygiene training as part of the ble for following up on late payments. Sanergy is also onboarding process, as well as follow-up visits through experimenting with a leasing model for landlords, with their emptying and/or sales teams. Such training rein- a monthly payment of a little more than US$8, replac- forces the importance of proper and hygienic use of the ing the US$350 installation payment and US$70 annual toilets through regular communication with customers, fee. This system targets landlords, whom Sanergy sees and the necessary resourcing and human capital deploy- as its principal future target market, and reduces the ment was provided in all cases. Menstrual hygiene waste sales cost because it takes less time, on average, to is sometimes collected in separate bins provided by the persuade them to sign up for a service that does not service provider and burned (as in the case of Sanivation require a down payment. From Sanergy’s point of view, and Sanergy), or it is left for the customer to throw away this approach helps generate better economies of scale, with the household trash. Evaluating the Potential of Container-Based Sanitation 13 Photo 1.1 • Examples of CBS Toilets a. SOIL’s ferrocement EkoLakay model d. Sanergy’s Fresh Life Toilet b. SOIL’s wooden EkoLakay model e. Separett toilet, used by x-runner c. Clean Team’s imported plastic model Sources: a–c, Adrien Mazeau; d, Sanergy; e, Julian Parker. 14 Evaluating the Potential of Container-Based Sanitation Containment The reliable sourcing of good-quality cover material has presented some challenges. The availability and The majority of CBS toilets are seated portable units sourcing strategy should be reviewed prior to a new that are placed inside the household (see photo 1.1). CBS operation or a major expansion. In 2017, x-runner All but one of these toilet types has a urine diversion started to face challenges obtaining sufficient quanti- system.3 Loowatt’s toilet is the exception and has a ties of sawdust because for each purchase (from various proprietary mechanism to encapsulate the combined small carpentry businesses), it has to physically check the urine and feces in biodegradable plastic film. Three quality and quantity available and negotiate a price.4 In of the four models reviewed are pedestal toilets, Kumasi, sawdust is readily available from large sawmills, designed for sitting on; however, Sanergy’s Fresh Life and its supply has been outsourced by Clean Team to a Toilet, which is either public or shared between mul- contractor. However, some customers reported maggots tiple households, has a squat plate. Clean Team uses and ants developing in the sawdust when the collection a seated toilet that is sometimes shared between fam- schedule changed from three times a week to two. SOIL, ilies, but seeing as these families tend to live under on the other hand, has been exploring the potential use the same roof for a prolonged period in a compound of compost as cover material. Sanergy’s franchisee oper- house, they know each other well and such intimacy is ators deal with sourcing cover material themselves, but generally acceptable. have a strong incentive to ensure its supply and qual- ity to maintain good hygiene standards and limit odor. The toilets vary considerably in price with a general This is a good example of how the franchise model can increase in convenience and comfort at higher prices. help outsource tasks that otherwise can be a significant SOIL has a ferrocement model that costs US$27, but, as logistical burden without compromising on quality. ­ it is handmade, it is not necessarily suitable for large- scale production. A cost of US$40 to US$50, including There is currently no CBS toilet model or system that is import costs, was recommended to Clean Team as a tar- specifically designed for users that practice washing for get (Ernst & Young [EY] 2017); the toilets it has been anal cleansing. One of Sanergy’s franchisees in an area with importing currently cost US$92 each. The Separett toilet a significant Muslim population raised this as an issue and is sold to x-runner by its foreign producer at a heavily provides customers with a small container of water so that discounted price. In this case, customers would likely they can wash over the urine hole. Sanivation rolled out a not accept the possible downgrading to a cheaper unit model to six households in the Kakuma Refugee Camp: because they see the current plastic toilets as easier to Early findings found that five households adopted this clean and maintain a hygienic state. ­ solution, but one did not accept it. Loowatt toilets can be used by anal washers as it collects all excreta—feces and A key component of most CBS systems is a good sup- urine—together, so the issue that other CBS service provid- ply of cover material to add to the feces after each use ers have of not mixing the two is not a problem for them. to prevent odors and flies. The most common cover It piloted service provision with anal washing to families material is sawdust, which has good odor-elimination together with Laguna Water (as mentioned previously). and desiccation properties, though its effectiveness varies with the wood species, dryness, and coarseness. Agricultural waste (for example, sugarcane bagasse and Emptying/Collection peanut shells) and ash or charcoal dust are also used. The cover material used depends on what materials are avail- The CBS service providers collect the feces either from able locally and are typically provided to users as part of within the customer’s home (or the public toilet), at the the service. doorstep, or at a drop-off point, depending on physical Evaluating the Potential of Container-Based Sanitation 15 constraints and customer preference. Containers that lockers for some groups of customers (typically six to 10) are full of feces are swapped with empty ones at the col- to leave their bags of feces when they leave home before lection point in most, but not all, cases. For example, the truck’s early morning ­ collection round. Most CBS x-runner’s customers remove bags of feces from the toi- service providers operate one or more transfer stations— let cartridge, which has a lower and wider profile than a sites where feces-filled containers can be temporarily standard bucket, and place them in standard off-the-shelf stored and consolidated for onward transfer. In Saner- buckets, which they seal and carry to the pickup point. gy’s case, these are differentiated into collection centers, x-runner washes and disinfects the collected buckets where the 45-liter containers collected from toilets are before putting them back into circulation for the next temporarily stored before onward transport, and transfer round. The bags used to line the feces containers are used stations, where the feces is repacked into 160-liter drums throughout the journey and are either removed before for trucking to the treatment site. As operations scale or during the treatment process (for example, by being up and coverage density increases in existing areas of sieved out) or they are biodegradable in nature (in the operation, the use of collection, temporary storage, and case of x-runner and Loowatt). Sanergy piloted the use of feces consolidation facilities will increase, and more than reusable canvas bags for 80 toilets, given that plastic bags one stage may be required for storage. Access to land are a significant cost and the Kenyan government legis- and buildings where the CBS services are provided will lated to ban their use in September 2017. As of May 2018, impact the collection, storage, transfer, and transporta- Sanergy had generalized the adoption of these reusable tion options that are available. bags, which are washed in an industrial process. Treatment and Reuse/Disposal Transport Some CBS service providers have opted to reuse the The form of transportation CBS service providers use feces to produce a marketable product, with feces- depends upon the terrain and road access and is usu- based compost (organic fertilizer) being the most com- ally a combination of handcarts, three-wheeled trans- mon. Blended with organic co-waste streams, including porters (auto-rickshaws or tuk tuks), tractor-trailers, an organic-rich cover material such as sawdust or agricul- flatbed trucks, and box trucks. In some cities, there are tural waste materials, feces-based composts improve the households/toilets accessible only by narrow alleyways or structure and organic content of soil. Across the globe, steep staircases, which preclude vehicles. Handcarts and monocropping and the application of large quantities of three-wheeled transportation modes are used to transport chemical fertilizer are exhausting soil—that is, destroy- feces or excreta (in the case of Sanergy) from the toilets ing their structure and reducing their organic content to and drop the feces at some form of transfer station, where critical levels. Byproducts from sanitation services could it is consolidated on trucks for haulage to the treatment provide a critical input to enrich soil quality in contexts site. The steep topography in the settlements in Lima where soils are being rapidly depleted, and CBS service where x-runner operates means that the only cost-­ providers have been working to market their products effective way to get the feces from households not directly accordingly. In the case of CBS, collected feces is fresh on the roads is for the customers to carry it themselves to (not partly or fully digested as it is in other sanitation a drop-off point, from which a truck will pick it up. service options), so it has greater methane production potential and does not need to be dried for composting. To optimize the use of transport, feces is usually tem- Because it is not diluted with urine or water, it carries porarily stored and consolidated at one or more points. less risk of household system misuse (such as having x-runner provides dedicated storage spaces referred to as solid waste disposed of in the toilet). 16 Evaluating the Potential of Container-Based Sanitation Other options for reuse of CBS products include and, therefore, are also sensitive to the availability of the co-waste inputs. Regulatory constraints have also been a • Animal feed, when the feces is fed to black soldier significant barrier to scaling up reuse: In Peru, x-runner fly larvae (BSFL) and such larvae is converted into is not allowed to sell its compost due to such constraints. animal feed; and • Fuel, either through the production of biogas (from Sanergy believes it will be able to turn a profit on its reuse anaerobic digestion) and its accompanying residue product sales, which it runs as a separate for-profit busi- that can be used for agriculture after appropriate ness, based on expanded production, optimization of the pathogen reduction or from solid fuel briquettes. production process, and the expansion of the distribu- Excreta reuse products have the potential to generate tion networks for the final products. However, this does significant revenues. However, this requires metic- ­ ervice not take into consideration the front end of the s ulous experimentation and optimization and the chain (capture, containment, and emptying), which is securing of reliable markets to achieve scale, in terms of run by the nonprofit and will likely continue to require both supply of the organic waste products and demand subsidies until a sustainable scale/density is achieved. for the reuse products. Even though most CBS systems separate urine from feces through urine diversion mech- CBS service providers that generate reuse prod- anisms at the containment stage, only Sanergy currently ucts sell them on the open market, often as branded collects the urine separately (and even it ultimately dis- ­products. Sanergy, SOIL, and Sanivation all sell their charges it in nearby sewers without attempting to reuse end-use products to a purely retail market—branded it). Some of the main reasons for this lack of emphasis farming inputs in the case of Sanergy and SOIL and solid on reusing urine—and why the urine is separated in the fuel briquettes in the case of Sanivation. SOIL is seeking first place—are the high costs associated with transport- output-based aid subsidies to supplement the US$280 ing liquids, drier feces is easier to transport, and any per ton that it receives for its compost. Sanergy is able malodor produced in the toilet is significantly reduced, to get a higher price (approximately US$400 per ton) for if not eliminated. The potential for urine reuse should be its compost in Kenya and has introduced high-protein further explored, given its high nutrient content and its animal feed as a second major end-use product. Sanergy relatively easy processing for soil application. and SOIL sell to a combination of commercial farmers and smaller customers such as smallholder farmers. None of the CBS service providers has run a profit yet Sanivation sells briquettes to roadside food outlets, from its reuse operations. Sourcing sufficient quan- restaurants, and hotels, as well as private individuals— tities of suitable co-wastes at low cost is critical for the it started with direct sales and is gradually building up profitability of the composting process. Co-wastes are pre- a retail distribution network to reduce sales costs. The dominantly agricultural wastes (for example, sugarcane briquettes are marketed based on their longer burn time, bagasse, peanut shells, stalks, and vegetable peels) whose greater heat production, and reduced smoke—as com- availability varies by season. Hence, different blends may pared to charcoal and firewood—and the fact that they be needed throughout the year, for which the ratio of feces contribute to stemming deforestation. Loowatt produces to co-waste needs to be adapted accordingly. Transport electricity for use on its treatment site, as well as a pas- will often be the major cost parameter for co-waste as it is teurized fertilizer and compost. likely to be sourced from farms and factories over a wide area. Solid fuel briquettes have a large proportion (between The treatment processes used and the products gener- 75 and 95 percent) of high-carbon co-waste (for example, ated by some of the CBS service providers reviewed are charcoal dust or residues from agricultural production) summarized in table 1.2. Evaluating the Potential of Container-Based Sanitation 17 Table 1.2 • Reuse Activities: Processes and Products Service Treatment processes Reuse products provider SOIL Aerobic composting: static pile then windrow turning, Compost branded as Konpos Lakay, with sugarcane bagasse co-waste at start of process. sold at US$280/t. x-runner Bokashi anaerobic composting followed by two Compost product. Not marketed due weeks of aerobic windrow ­composting, with effective to a lack of regulatory framework for microorganisms added at the beginning of each stage. treated feces reuse. Sanergy Aerobic composting with a variety of agricultural/ Evergrow compost sold at US$400/t. organic co-waste materials. BSFL digestion of feces. Pure Protein animal feed, under development. Sanivation Mixing feces with high-carbon material (for example, Fuel briquettes sold for between ash or carbonized rose waste) and pressing and US$150 and US$180/t. drying of briquettes. Loowatt Anaerobic digestion to produce electricity. Pasteurized Products yet to establish a market— digestate residue sold as is or converted to compost willingness to pay study conducted. via aerobic composting followed by vermicomposting. Note: BSFL = black soldier fly larvae; t = ton. Notes References 1 The concept of privacy depends on the context: In Haiti, there has EY (Ernst & Young) and WSUP (Water & Sanitation for the Urban not been a problem with people finding space, even in very small Poor). 2017. The World Can’t Wait for Sewers: Advancing Container- dwellings, whereas in Kenya, there seems to be resistance to having Based Sanitation Businesses as a Viable Answer to the Global an in-home toilet in a small dwelling. Sanitation Crisis. London, UK. 2 Fecal sludge management is defined here as the emptying of pits, Suntura, C., and B. I. Sandoval. 2012. Ecological Sanitation in Peri- vaults, septic tanks, and so on, and the treatment of the resultant urban Area of El Alto City, Bolivia. Case study of SuSanA projects. fecal sludge (or feces in CBS cases) at plants specifically designed to treat concentrated fecal sludge and/or septage. Tilley, E., L. Ulrich, C. Lüthi, P. Reymond, and C. Zurbrügg. 2014. 3 In the case of SOIL, though household toilets are urine-diverting, Compendium of Sanitation Systems and Technologies. 2nd rev. ed. the rental service EkoMobil is not. The toilets used for events Duebendorf, Switzerland: Swiss Federal Institute of Aquatic Science are larger and come with more cover material to keep them dry and Technology (Eawag). during the time of use, and then the whole structure is trans- ported to the treatment facility and the urine is treated with the “Utility Business Model (Piloting Two Portable Toilet Systems (PTS) feces. in Laguna, Philippines).” 2018. Sustainable Sanitation Alliance. Last modified August 9. https://forum.susana.org/161-sanitation​ 4 As of May 2018, x-runner has entered working agreements with -as-a-business​-and-business-models/22429-utility-business-model​ three larger sawdust suppliers, which has alleviated this pressure. -piloting-the-pts-in-laguna-philippines?setGT=0. 18 Evaluating the Potential of Container-Based Sanitation C HA P T E R 2 • L E GAL AND P OLI CY E NVIRON ME NT FOR C B S SE RVIC ES This chapter reviews the legal and policy environment Peru released a new sanitation policy in January 2017, for container-based sanitation (CBS) services. and regulations are under preparation. Institutional roles overlap, however, and the Ministry of Housing, The legality of CBS services in the different contexts Construction and Sanitation is preparing to imple- where they are currently implemented varies. In Ghana, ment a program that will take over water supply and Haiti, and India, the legality of the CBS approach is seen as sanitation and asset development in Lima from the tenuous, whereas in Kenya, there is a defined legal category city’s utility, Servicio de Alcantarillado y Agua Potable of “cartridge-based toilets,” which provides a conducive de Lima (Lima Sewerage and Water Supply Service; environment for CBS businesses. As sanitation policy SEDAPAL). In Haiti, there is clarity on institutional evolves, CBS actors become better organized globally and roles, with the Direction Nationale de l´Eau Potable the regulation of sanitation services is strengthened in et de l´Assainissement (National Directorate of Water countries where it is currently weak. The explicit recogni- and Sanitation; DINEPA) as the national coordinating tion of CBS services is also anticipated to increase. Robust agency; urban sanitation policies and regulations are regulation of CBS services will be of growing importance slowly being developed from a low base. In the Phil- if more entrepreneurs are attracted to providing such ser- ippines, the sanitation policy is well-developed, and vices so as to mitigate the risk of poor-quality copycats. the government’s strategy focuses on promoting non–­ sewer-based solutions in the urban environment as part of a mix of solutions, but regulation of urban sanitation Overall Legal Environment for Sanitation services suffers from fragmentation. In the four countries reviewed in the case studies, the current landscape for the sanitation sector is charac- Legal Regimes for CBS Services terized by fragmented and overlapping institutional responsibilities and major changes with regard to pol- The legal regimes under which CBS services are cur- icies and/or institutional roles. In January 2017, Ghana rently provided are summarized below. These range established a new Ministry of Sanitation and Water from countries in which the legality of CBS is tenuous Resources, to which responsibilities have been gradu- (such as in India, Haiti, and Ghana)1 to those where CBS ally transferred from other ministries. Kenya has a new is legally possible but not specifically encouraged (such Environmental Sanitation and Hygiene Policy (KESHP), as in Peru) to others where the legal regime has recently but a regulatory framework needs to be developed and been modified to explicitly allow for CBS (such as in the the policy emanates from the Ministry of Health, whose Philippines and Kenya ). The specific legal and regula- sanitation engagement hitherto has been mostly limited tory regimes are discussed in the following paragraphs, to rural sanitation promotion. Currently, the national beginning with those countries where the legality of CBS environment regulator, the National Environment is more tenuous. Management Authority (NEMA), provides the closest regulation of Sanergy’s operation through the licensing In India, a 2013 law banning “manual scavenging” of the vehicles it uses to transport excreta. and the handling of fresh feces presented a particular Evaluating the Potential of Container-Based Sanitation 19 challenge to CBS service providers. Sanitation First has service provision. Septic tanks and septage treatment overcome this by developing a toilet with four containers have been formalized under the private concession that can be rotated in the vault to ensure that feces is the contracts in Manila with the capital’s two water and san- required 28 days old before the containers are manually itation utilities and are very much part of the plans and removed and the feces transported to a composting site. practice for universal service provision. Manila Water’s piloting of CBS is a clear sign that additional non–­ In Haiti, CBS is allowed but not officially referenced in sewer-based approaches are needed to reach the any government document. It most closely corresponds unserved (Asian Development Bank 2013). to ecological sanitation, which is allowed in urban areas only if there is adequate domestic demand for the com- In Kenya, CBS has been recognized as a legal class post produced. A reference document for sanitation is of improved sanitation in the KESHP (2016–30). being developed, and Sustainable Organic Integrated The policy is new and signaled a shift in focus of the Livelihoods (SOIL) is advocating with DINEPA for the Ministry of Health from promoting rural sanitation to inclusion of CBS in this document to provide more solid looking more broadly at hardware and service systems. legal ground for its services. As of May 2018, these con- A detailed regulatory framework has yet to be developed, versations were still ongoing. and enforcement capacity is weak. The recent renaming of the Ministry of Water and Irrigation to the Ministry In Ghana, the legal situation is ambiguous, and CBS of Water and Sanitation is an important development for is neither prohibited nor supported by national level the evolution of urban sanitation in the country. How- institutions. At the municipal level, it is cautiously ever, in the absence of the president’s executive order, any supported. expansion of the mandate of the new ministry remains In Peru, CBS is allowed but not specifically encour- unclear. Explicit recognition of CBS as improved sanita- aged. The policy framework is agnostic on technology tion in Kenya provides a platform upon which support and requires service providers to be incorporated and for CBS approaches can be built, thus providing a strong licensed as an entidad prestadora de servicios de san- basis for its development. Appropriate regulations and eamiento (sanitation service provider; EPS), with strengthened enforcement mechanisms will be required environmental impact assessments (EIAs) as a prereq- to provide a level playing field on which CBS can com- uisite for acquiring such a status. x-runner did not have pete with alternative approaches. EPS status at the time of writing but was outsourcing the transport process to a private company with EPS status. A gap in Peruvian policy means that reuse of treated Regulation of CBS Services feces is illegal, but reuse of wastewater and the biosolids from wastewater treatment (WWT) is legal, thereby pre- The agencies in charge of regulating CBS services senting a barrier to a full CBS sanitation chain approach in each of these countries are shown in figure 2.1, by not allowing the sale of reuse products. according to the steps of the sanitation service chain they oversee. The main regulatory body for CBS ser- In the Philippines, CBS matches the legal “box and can vices varies from country to country but is usually the privy” category. Although the regulatory environment public health/water and sanitation sector regulator. The is somewhat fragmented, the Philippines has a com- current significant exceptions are Kenya, where the envi- prehensive policy framework, and the government is ronment sector regulator, NEMA, is principally respon- currently shifting its focus away from sewer-based solu- sible, and Kumasi, Ghana, where the local authorities tions, which are considered unaffordable for universal provide this function. Moving along the service chain 20 Evaluating the Potential of Container-Based Sanitation Figure 2.1 • C  BS Regulatory Bodies, by Country and Typical Regulation of Alternatives Primary Secondary Containment Emptying Treatment Reuse/Disposal transport transport Sanergy Quality standards (KeBS) Nairobi, Kenya Environment regulator (NEMA) NEMA Sanivation County government Naivasha, Kenya Environment regulator (NEMA) NEMA SOIL Haiti Water and sanitation regulator (DINEPA) CBS service providers x-runner None/unclear No regulations for fecal Peru (DESA) Water and sanitation regulator (SUNASS) sludge reuse Clean Team Environmental Kumasi, Ghana health officers Local government (Kumasi District Assembly) Manila Water Department of Philippines health Department of health/water quality management area governing boards Loowatt Madagascar Water and sanitation regulator Local Sewer-based Water and sanitation regulator Environment regulator Conventional government Local Environment regulator/ Utility OSS and FSM government water and sanitation regulator regulator Environment regulator Note: DESA = Dirección Ejecutiva de Salud Ambiental (Executive Directorate of Environmental Health); DINEPA = Direction Nationale de l’Eau Potable et de l’Assainissement (National Directorate of Water and Sanitation); KeBS = Kenya Bureau of Standards; NEMA = National Environment Management Authority; SUNASS = Superintendencia Nacional de Servicios de Saneamiento (National Superintendence of Sanitation Services). The color of the bars show the sector responsible for the regulation of that segment: purple: water and sanitation regulator; green: environmental regulator; orange: water and sanitation and environmental regulators; teal: health regulator; blue: local government; white: none. Dotted line indicates shared responsibilities. from the toilet to the treatment plant, the health haz- environment (rivers, streams, waste ground), but as this ard generally becomes more diffuse as the feces moves is typically done close to population centers to reduce from densely populated areas to less populated areas and transport costs, it is a bigger risk to human health than to from more open forms of transport (handcarts and tuk the environment—and for the reuse of the treated feces. tuks) to closed forms (trucks). As is the case with fecal sludge management (FSM), an environmental agency Existing regulation of CBS services currently pays would appear an appropriate regulator for the transport little attention to the activities undertaken by house- of feces, which is sometimes illegally tipped into the holds or toilet operators (in the latter case, for Evaluating the Potential of Container-Based Sanitation 21 Sanergy), leaving the service providers to self-regulate standards could support the development of public sec- these components. Although regulators often specify tor contracts and results-based financing models and, certain types of sanitation infrastructure and/or design ultimately, enable broader replication of CBS service parameters (such as for the construction of septic tanks), models. This would also enable quality benchmark- these regulations are seldom enforced in practice. Yet ing across the board and help ensure that consistent the household part of the service chain—be it for more high-quality services are promoted. Potential perfor- traditional FSM or for CBS—involves a large number of mance indicators could include the percentage of missed different actors whose public health awareness, attitudes, collections, the percentage of feces or excreta that is and behaviors usually vary widely. This contrasts with safely treated, and the percentage of feces or excreta that the downstream part of the service operated by CBS is reused (independently of whether it is sold). providers, where a largely trained and professional team conducts its activities (collection2 and transport) on a Finally, most countries where CBS is currently being daily basis and according to an established system. implemented have policies that allow and encourage private sector participation, but the legal and regu- For CBS services, therefore, the regulation of the house- latory frameworks for such participation are often hold component of service should be similar to that of not well-developed. Private companies need to obtain on-site sanitation (OSS) with FSM, which would require registration and accreditation as service providers control of the quality of the containers and the timeliness (that is, EPS) in Peru. The Technical Organism for the and quality/effectiveness of the emptying; the quality Management of Sanitation Services (OTASS) was set and timing of hygiene promotion by the CBS service up in 2013 to provide support for and build capacity of provider; the frequency and effectiveness of monitoring sanitation EPS, but some of its responsibilities overlap by the CBS provider; and the behavior of the households with that of the sanitation regulator, the Superinten- or private toilet operators. The current CBS service pro- dencia Nacional de Servicios de Saneamiento (National viders are supervising these areas themselves, but as they Superintendence of Sanitation Services; SUNASS). scale up their services and as new actors join the market, Private sector participation is required in Ghana by self-regulation will not be appropriate, especially in situ- the National Environmental Sanitation Policy, with ations where CBS is in direct competition with another the provisos that private monopolies are banned in sanitation service (including with a rival CBS service). large towns and that a minimum of 20 percent of the volume of environmental sanitation services are pro- In addition, an explicit regulatory framework for the vided by the public sector. In Kenya, the sanitation reuse of treated feces in agriculture, and for other end policy states that the government will support private uses, would enable some of the CBS service providers sector participation in sanitation provision by creat- who treat their feces to high standards for reuse to effec- ing clear standards and guidelines and creating legal tively market their products. This is the case for x-runner, instruments, such as exemptions, but other than a who currently faces a legal barrier that precludes any use law on private sector participation, these instruments of associated products. were still pending as of May 2017. The institutional framework for sanitation in Haiti states, “Private sec- One of the barriers to clearer regulatory arrangements tor participation is encouraged. …The private sector is is the lack of definition of what constitutes a “qual- called upon to participate in sanitation sector develop- ity” CBS service. The development of overall service ment through partnerships.” (DINEPA 2014) 22 Evaluating the Potential of Container-Based Sanitation Notes References 1 In Kumasi, Ghana, the Kumasi Metropolitan Authority (KMA) offi- Asian Development Bank. 2013. Philippines: Water Supply and cially recognized in January 2018 that Clean Team was compliant Sanitation Sector Assessment, Strategy, and Road Map. Mandaluyong with sanitation bylaws. City, Philippines: Asian Development Bank. 2 The use of the term collection here recognizes that in some cases (x-runner and SOIL), the households conduct the emptying of the DINEPA (Direction Nationales de l’Eau Potable et de l’Assainissement). toilet and the CBS service provider then collects the sealed waste 2014. Document d’Orientation Stratégique pour l’Assainissement en Haiti containers at doorsteps or a pickup point. 2014-2018. Ministère des Travaux Publics, Transports, Communications. Evaluating the Potential of Container-Based Sanitation 23 C HA P T E R 3 • C B S S E RVI C E PE RFOR M AN C E This section assesses the performance of selected Although this reflects the clear and assertive application of ­ container-based sanitation (CBS) models in terms of the service providers’ debt and management policies, these service delivery. A clear indicator of service performance is periods of closures have slowed overall take-up rates and customer growth: All CBS service providers have achieved set service providers back, which can explain, in part, the steady but relatively slow growth in customer numbers since relatively slow growth rates. In some cases, moving into their creation, though some have faced temporary lulls as new customer segments (Sanergy), new cities (SOIL), or they uninstalled services due to nonpayment or focused on new areas of cities where they currently operate has helped improving the efficiency of their service models. In terms of drive growth. Over the long run, however, growth has customer service, performance has generally proved satis- been subject to capacity constraints, such as toilet manu- factory for customers and superior to available alternatives facturing capacity (in the case of Sanergy) and the capacity in their areas of operation, based on customer interviews, to attract, onboard, and retain customers (in the case of focus group discussions, and customer surveys conducted SOIL, who had been struggling with payment collections by the service providers themselves (where available). until the introduction of mobile payments). At different stages in their companies’ evolution, Clean Team and SOIL deliberately put customer growth temporarily on hold to CBS Service Customer Growth focus on improving the efficiency of their business models. Since they launched, each of the four CBS service pro- CBS service providers have experimented with various viders assessed for this report have achieved steady, if strategies to drive growth, including changing sales relatively slow, customer growth over time, as shown in approaches, incentivizing referrals, reducing prices, den- figure 3.1. The graphs for Sustainable Organic Integrated sifying services in existing areas of operation, opening Livelihoods (SOIL) and Sanergy also illustrate the rela- up new areas of operation, and targeting new customer tive contribution of different cities and different business segments. For example, though Sanergy’s residential models, respectively. Even though all the CBS service model continued to lead growth into 2017, it identified providers reviewed had been in operation for five to nonresident landlords (that is, landlords not living in seven years, the number of CBS systems they operated the plots where they rent out dwellings) as a new market was around the 1,000 mark as of May 2017. segment to target, building on the surge in popularity of its toilets aimed at households. Average customer growth rates range between 15 to 25 new toilet facilities installed per month, with the largest Looking to the future, it is important to note that CBS general number of new customer installations observed works best when a high proportion (density) of the in all four cases around 40 units per month. Exceptions population subscribes to the service in a given service include months when as many as 75 new customers signed area. This has implications for CBS’s interaction with up for SOIL and 65 for Sanergy. Overall, the CBS service other viable sanitation alternatives where they exist, as providers have experienced surges in growth, but they it would likely only be seen as a viable service approach have also had brief periods of toilet closures/withdrawals where the level of service provided is currently poor. by customers who had accumulating debts or who had Similarly, densification may be difficult where other san- consistently failed to operate their toilets hygienically. itation alternatives are already in place but do not reach 24 Evaluating the Potential of Container-Based Sanitation Figure 3.1 • Customer Growth for CBS Service Providers Examined in Case Studies (as of May 2017) Clean Team customer growth SOIL customer growth 1,400 Toilets installed and operational 1,200 Toilets installed and operational 1,200 1,000 1,000 800 800 600 600 400 400 200 200 0 0 Oct. 13 Jan. 14 Apr. 14 July 14 Oct. 14 Jan. 15 Apr. 15 July 15 Oct. 15 Jan. 16 Apr. 16 July 16 Oct. 16 Jan. 17 Apr. 17 Aug. 14 Nov. 14 Feb. 15 May 15 Aug. 15 Nov. 15 Feb. 16 May 16 Aug. 16 Nov. 16 Feb. 17 May 17 Date Date Cap-Haïtien Port-au-Prince Sanergy customer growth x-runner customer growth 1,200 800 Toilets installed and operational Toilets installed and operational 1,000 600 800 600 400 400 200 200 0 0 11 12 12 12 13 13 13 14 14 14 15 15 15 16 16 16 17 Jan. 15 Mar. 15 May 15 July 15 Sep. 15 Nov. 15 Jan. 16 Mar. 16 May 16 July 16 Sep. 16 Nov. 16 Jan. 17 Mar. 17 May 17 Nov. Mar. July Nov. Mar. July Nov. Mar. July Nov. Mar. July Nov. Mar. July Nov. Mar. Date Date Commercial Other Plot School Sources: Clean Team, SOIL, Sanergy, x-runner. Note: Dotted lines indicate unavailable data. all households. Where applicable, planners could iden- satisfaction and CBS providers’ responsiveness to customer tify “designated service areas” for CBS service providers complaints were also assessed in the four case studies. to foster the densification and scale-up of their services. Safety: CBS Services are Considered Safe, Value of CBS Services to Customers and the with Some Areas for Improvement Community CBS services provide comparable safety to flush toilets The value of CBS services to customers was reviewed based and sewerage for the containment, emptying, and col- on key dimensions of customer experience, including safety, lection stages of the sanitation service chain.1 When reliability, and affordability. Current levels of customer feces is collected by CBS service providers, it is sealed in Evaluating the Potential of Container-Based Sanitation 25 plastic or biodegradable bags, which, in the case of most the existing sanitation services in the cities where CBS models, are inside sealed plastic containers. Plastic they operate. Cap-Haitien has no existing wastewater bags of feces are removed from the containers only at treatment (WWT) facilities,2 and facilities in Nairobi, the customers’ toilets or in areas under the control of the Kumasi, and Lima leave a large proportion of waste- CBS service provider—a transfer station or a collection water either untreated or inadequately treated. Only truck (in the case of x-runner). For their protection, Kumasi has a fecal sludge treatment facility, but it was operators wear gear and follow clear excreta-handling nonfunctional at the time of the case study (May 2017). guidelines, as is the safety standard for other compara- Treatment and resource recovery processes operated by ble processes such as fecal sludge management (FSM). CBS service providers are, in general, providing a high As the CBS service providers remain relatively small, level of treatment (composting or anaerobic digestion, well-managed companies, they tend to apply these safety or transformation into briquettes). guidelines more tightly. Accidents (dropped containers and split bags) are possible, but due to the limited size Reuse products generated by CBS service providers of the containers, these kinds of incident would have a who are active in this market conform to high safety low impact and could be remedied immediately. In such standards. Sanergy’s compost and animal feed products instances, the main risk would be to the collection staff, have proved to be safe for their intended use by inter- who are provided with personal protective equipment national standards and Kenyan regulators. Independent and regular vaccinations. Only one such incident was verification or certification of SOIL and x-runner’s reported in the four case studies during interviews with composting processes and products are not available staff (that is, spillage of the container contents in the as Haiti does not have a licensing system for compost street, reported by the CBS service provider itself). and Peruvian law currently does not allow for reuse of treated feces. Safety is therefore assessed by the two By contrast, on-site sanitation (OSS) solutions can be CBS service  providers themselves, and they both hold deemed safe where pits are adequately lined and do not let themselves to high standards. For example, SOIL had its in rainwater, though this is rarely the case in many vulner- composting process verified and endorsed by the U.S. able communities where CBS service providers operate. In Centers for Disease Control and Prevention (CDC), and addition, OSS services often involve unsafe manual empty- it tests every batch of compost for indicator pathogens ing and transportation processes in harder-to-reach areas. (Berendes et al. 2015). In some cases, the local context and/or preferences may It is worth noting that none of the CBS service dictate the participation of customers in the removal approaches that were assessed provide for the manage- of containers from households, as well as their trans- ment of greywater at the household level. This means portation and subsequent emptying. This household that in areas with high water consumption, additional participation comes with potential health risks due to greywater management solutions need to be established the possible exposure to feces, so monitoring, follow-up to reduce the risks of disease and nuisance spreading hygiene promotion, and enforcement of sanctions by due  to stagnant greywater. At present, populations liv- CBS service providers for improper operation all need to ing in the CBS service areas would typically dispose of be strict. Out of the four case studies reported here, only greywater in nearby drainage canals or in old pit latrines x-runner involves customers in the emptying process. where they exist (such as in the case of x-runner). CBS treatment and resource recovery processes Table 3.1 compares the levels of safety provided by CBS are superior to the municipal treatment related to services to that of the other sanitation services currently 26 Evaluating the Potential of Container-Based Sanitation Table 3.1 • S  afety and Potential Reach of Sanitation Services: Comparison between CBS Services and Safest Viable Alternatives in CBS Service Providers’ Areas of Service Safety of sanitation service chain Potential reach Containment Emptying Transport Treatment Disposal/reuse Nairobi, Kenya Sanergy CBS CBS In sealed containers Composting/BSFL Extensive Sewer-based Public pour-flush Sewer WWT ponds River Limited mostly to toilet periphery Lined pits + Lined pit Manual Drum on None To river/waste Extensive—where FSM wheels ground space allows Kumasi, Ghana Clean Team CBS In sealed containers Septage TP Landfill Extensive CBS (­partially functional) Household Lined pit Vacuum tanker Septage TP Landfill Medium/ latrines (­partially functional) extensive—reaches most areas Cap-Haitien, Haiti SOIL CBS CBS In sealed containers Composting Extensive Lined pits + Lined pit Manual Hand carts None To hand-dug pits Extensive FSM and waterways Flush toilet + Septic tank Mechanical Trucks Variable Not regulated Medium FSM Lima, Peru x-runner CBS In sealed containers Composting—if regulation can be Extensive CBS established Sewer-based Household flush Sewer WWT plant River Difficult to reach toilet all areas Municipal UDDT with three Manual Municipal Composting—if regulation can be Medium—requires UDDT months’ storage trucks established space and access Note: Green = safe; yellow = partially safe; red = unsafe. Where sewer-based alternatives are not mentioned (as in Cap-Haitien, Haiti and Kumasi, Ghana), these solutions would not be implementable in the near to medium term. BSFL = black soldier fly larvae; CBS = container-based sanitation; FSM = fecal sludge management; TP = treatment plant; UDDT = urine-diverting dry toilet; WWT = wastewater treatment. Note on potential reach: Potential to provide corresponding sanitation service to all households in specific targeted geographical area. Evaluating the Potential of Container-Based Sanitation 27 provided in the same geographical areas. It also assesses or schools being locked when excreta collectors arrived. the potential reach of these services given common con- Between March and May 2017, there were only two ditions in such areas. complaints (out of approximately 870 customers) for missed collection services. The customers interviewed In September 2017, the World Health Organization in the four case studies indicated that missed collections (WHO) started supporting CBS Alliance members with were rare and that they were satisfied with the collection the adoption of its Sanitation Safety Plan (SSP) to review systems. implications for CBS services. The WHO initially devel- oped this approach to identify, prioritize, and manage Missed collections were remedied as soon as they were the health risks from sanitation systems in a systematic reported. x-runner’s transportation system involves just manner (“Sanitation Safety Planning” 2015). The SSP one truck that covers different routes each day, mean- includes three essential actions: First, mapping the differ- ing that a missed household would need to wait a whole ent components of the sanitation system and identifying week. To overcome this problem, x-runner provides two the health risks of highest priority. Second, establishing bags and two carrying buckets to each household, which control measures at critical points in the sanitation sys- effectively affords spare capacity in case toilets fill more tem and mechanisms to ensure that a failure to control rapidly than expected. In addition, it has custom-made is being detected in a timely manner. Third, preparing a storage points (referred to as “lockers”) in the commu- management plan that details procedures and corrective nity, which allows customers to drop off their bags of actions to be taken to minimize health risks. The under- feces at a time that best suits them.3 Sanergy is the only taking and dissemination of SSP assessments could play company of the four reviewed that provided information an important role in providing assurance to authorities on the number of complaints and their response time and the public that CBS services can be managed in a to them, which is information that it routinely tracks. safe way, as well as providing a potential benchmark Each type of complaint has a target timeframe for res- with other sanitation service provisions in a given area olution. Sanergy reported a steady improvement in the or city. timeliness of case resolution from about 20 percent from July to October 2016 to 80 percent in April 2017. SOIL Reliability: CBS Collection Services are Reliable reported receiving two complaints (out of approximately 870 customers) for missed collection services between The collection services of the CBS service providers March and May 2017. in the four case studies were reported as reliable, with very low rates of missed collections. Missed collections Although the customers interviewed consider the were reported to be less than 1.5 percent after totaling services reliable, CBS service providers should have the average recent monthly missed collections reported contingency plans in place to preempt serious disrup- by SOIL, Clean Team, and Sanergy. Missed collection tions in order to continue providing services as much as data for the months reviewed during the study were possible. Currently, it is not clear whether CBS service available only for SOIL, Clean Team and Sanergy. Clean providers have clear strategies for coping with poten- Team recorded 0.8 percent missed collections in March tial disruptions to their operations, which could occur 2017, which reduced to 0.2 percent in April after intro- due to staffing issues, natural disasters (such as hurri- ducing a system of pairing temporary collectors with canes or floods) or manmade disasters (such as riots or full-time, experienced collectors who knew the routes civil conflict), epidemics, or interruptions to external better. Sanergy’s 2 percent missed collection rate in the funding that is critical for continued service provision. first four months of 2017 was mostly due to compounds Although these might be low-probability events, their 28 Evaluating the Potential of Container-Based Sanitation potential to disrupt collections makes them a threat CBS Services are Usually Priced in Line with Locally to the long-term acceptance of CBS, whereas contin- Available Alternatives gency plans involving local public health departments, and other entities as appropriate, could help make CBS The price for users reflects CBS service providers’ services an asset in high-density, poor urban areas that pricing strategies rather than actual costs, given that are prone to such unexpected events. During epidem- the majority of their costs are currently subsidized ics of infectious diseases, CBS collection staff face high (see Chapter 4 for more detail). exposure, but they also provide a potential source of early warning/surveillance information. Through their The CBS services reviewed were found to be priced direct and regular contact with households, they could at similar overall levels to the sanitation alternatives quickly inform the appropriate institutional/regulatory in, or close to, their service areas, as illustrated in bodies if infectious disease symptoms occur or become table 3.2. Alternative sanitation services include public prevalent. toilets connected to sewers or lined pit latrines with FSM approaches. CBS services can be more resilient to climate varia- tions, particularly to floods and droughts, than are CBS service providers’ pricing strategies take account other solutions. In Haiti, CBS service users highlighted of the prices paid for other sanitation services, in addi- that they could continue to use their toilets during tion to the following: floods, whereas traditional latrines become unusable. In Nairobi, the fact that Fresh Life Toilets are waterless is a • The low and precarious incomes of the target pop- distinct advantage in a water-scarce environment where ulations limit how much they are able to pay. As there is no piped water and where household water CBS services are currently subsidized, emphasis is needs to be purchased in small volumes and hauled from usually placed on setting tariffs they deem users are considerable distances. willing and able to pay. Table 3.2 • Tariff Charged to Users for Sanitation Services: Comparison between Providers and Alternatives Service cost to users/year Sanergy Clean Team SOIL x-runner CBS services US$63a US$106 US$36 US$108–US$144 Fee-charging public toilets US$63a US$125–US$167a OSS solutions Pit latrine, pour-flush, Pit latrine Household pit or septic tank latrine ·· Upfront installation costs US$350–US$1,160 US$320–US$480 US$263 ·· Avg. desludging cost/HH/ US$7.5–US$40.5 US$7.3–US$36.5 US$49 year Note: Empty cells indicate that these services are not commonly present in the areas served by container-based sanitation (CBS). Avg. = average; HH = household; OSS = on-site sanitation. a. Estimated based on a family of two adults and three children, each making one paid visit per day. Evaluating the Potential of Container-Based Sanitation 29 • CBS is novel, and even if the service is often supe- Once installed, toilets are affordable so long as they pro- rior to other options, people can be reluctant to pay vide minimally acceptable service to the owners and for something they are not yet convinced will work. users. However, when a pit latrine or septic tank needs • CBS becomes more cost-efficient when more cus- emptying or when it floods due to heavy rains, the cost tomers are clustered together in a service area. of desludging might be unaffordable to the household. Hence, it is preferable to charge a price that will Some SOIL customers interviewed for this study, for encourage a significant proportion of the popula- example, said that they abandoned latrines (and adopted tion to adopt the service to reduce the overall cost CBS) because they could not afford the desludging of the per person served. former. Desludging can be a fraction of the annual cost of CBS services (as shown in table 3.2), but its “lumpy” CBS service providers have adapted their businesses and unpredictable nature makes it difficult for people to the limited and fragile cash flows of their target with unreliable incomes to plan for and afford. Sewerage markets. x-runner initially charged a signup fee but later services are usually charged on a monthly basis, though removed this as the novelty of the service was already a initial sewerage connection costs can be unaffordable, significant barrier to potential customers and the instal- particularly when network extensions are necessary to lation fee was seen as discouraging many from “making install a new sewerage connection and in-house plumb- the leap” and signing up. Sanergy operates a credit ser- ing adaptions are needed. vice in partnership with a microlender, Kiva Bank, but is also experimenting with a model that involves no signup Comparing the annual costs of alternative sanitation fee for franchisees. At the other end of the spectrum, services does not take into account affordability con- SOIL is considering implementing an installation fee straints or the difficulties that households face in setting as  a way to demonstrate the willingness of new clients aside the necessary substantial sums for desludging or to pay. in getting credit for the initial installation costs and sub- sequent operation and maintenance. One advantage of It is difficult to compare the prices of CBS services CBS services is that monthly regular charges can be a for users to those of other sanitation options because convenient way for households to smooth out the costs of differences in the timing of payments. From a of paying for a reliable sanitation solution over time.4 customer cash flow point of view, poor customers find that having a regular monthly charge—and not fac- Prices charged to customers, though comparable to ing an upfront cost—makes it easier for them to pay other options offered in CBS service areas, can be for and access CBS services. By contrast, household significantly higher than what is charged to custom- toilets for OSS or sewer interventions are expensive ers in areas where sewerage services exist, especially to construct, and many households are put off by the when the latter benefits from public subsidies. If the initial installation costs. In Kumasi, for example, the centralized water supply and sewerage services could be cost of building a household-level OSS solution, such brought to households in the peri-urban areas of Lima, as a septic tank, can be as high as US$1,160, which is for example, the total water and sewerage cost would be unaffordable for many low-income families. The cost around US$7 per month or US$84 per year (based on of using public toilets, which is the only option for current social tariffs for water and sewage). This is less many Kumasi residents, is also substantial (though it than the US$10 to US$15 per month that people are cur- is more regularly spread over time). Clean Team used rently paying for water alone, and it is less than the US$9 both of these as benchmarks for defining the price of to US$12 per month that they would pay for CBS ser- its own services. vices which cost between US$9 and US$12 per month. 30 Evaluating the Potential of Container-Based Sanitation This  indicates that because residents in informal set- suggested that user behavior could also be at least part of tlements are facing much higher sanitation and water the cause, with some toilets showing signs of not being supply charges, and because those living in areas serviced properly cleaned and maintained (for example, two of by the centralized water supply and sewerage systems are 15 inspected were found to be flooded with urine). This already comparatively better off in general, water supply highlights the importance of including hygiene promo- and sewerage subsidies in Lima could be better targeted. tion in the CBS sales and customer support processes, as well as having mechanisms to maintain standards and possibly sanction customers who do not maintain ade- Customer Satisfaction is High quate standards. x-runner uses biodegradable bags but found that they can become weak and break in the sum- The customers of the four CBS service providers mer months due to heat. Thus, it provides two bags (so reviewed were positive about the quality of service.5 In that they can be switched before one got too full), and in particular, customers liked the services for the improved hygiene and the lack of smells and flies, which are asso- early 2017, it replaced the biodegradable bags with used ciated with alternative sanitation options such as OSS. plastic bags for several months as they have a lower risk In Ghana, some government officials associate CBS with of breaking down. bucket latrines, which are now illegal there; the cus- tomers interviewed for the case study, however, had not Customer Complaints are Promptly Handled made such an association. In Haiti, many of the custom- ers live in low-lying, coastal parts of Cap-Haitien and Collection teams making regular visits provide the main Port-au-Prince, where several of the people interviewed point of contact and opportunity for feedback on CBS in the focus groups6 mentioned the fact that they can and present a first point of contact for households to use their EkoLakay (CBS) toilets during flooding epi- report problems. sodes, whereas pit latrines overflow and contaminate the The CBS service providers studied have well-function- streets, was a distinct advantage. ing mechanisms for receiving customer complaints Customers had been waiting a long time for sewerage and respond quickly with remedies when they arise. network expansion or for the provision of other ade- Customers are provided the telephone numbers of cus- quate sanitation services did not see CBS services as a tomer support staff or account managers. Complaints transitory solution but rather as a long-term, reliable are logged, passed on to operations teams for action, solution. and tracked to resolution. Sanergy designates target res- olution times for different categories of complaints and The few complaints raised regarding the CBS services tracks the percentage that is resolved within the spec- largely related to quality issues with the consumables ified time target. As Sanergy’s direct “customers” are associated with the services. Some of Clean Team’s franchised toilet operators, landlords, and schools, and customers raised concerns about the switch from collec- the toilets have a higher number of daily uses, it deals tions three times a week to twice a week, saying that this with a significant number of maintenance requests. The can result in maggots or insects developing in the saw- percentage of Fresh Life Toilet-related complaints that dust. This could potentially be due to the quality of the were dealt with within the assigned time limit improved sawdust or humidity levels, as similar complaints were from 20 percent (when tracking began in July 2016), to a not found in x-runner’s service area, where collections little less than 80 percent in April 2017, showing that the take place on a weekly basis. However, observations adoption of clear targets can accomplish a lot in terms of during the undertaking of the Clean Team case study raising service quality. Evaluating the Potential of Container-Based Sanitation 31 case, both franchisees (that is, toilet operators) and users were inter- Notes viewed. Specifics of the surveys are reported in the case studies. 6 See appendix A for details on the focus groups. 1 These assessments were based on the observations captured under the study as well as external assessments by external academics. 2 As of May 2018, a WWT facility that was previously operational in Port-au-Prince had closed. 3 As of May 2018, x-runner had contracted a new service provider References for the collections, allowing for more spacious trucks and flexibility, and has improved its collection efficiency. Berendes, D., K. Levy, J. Knee, T. Handzel, and V. R. Hill. 2015. 4 Similar results can be achieved through providing financing access “Ascaris and Escherichia coli Inactivation in an Ecological Sanitation to households interested in investing in sanitation infrastructure. System in Port-au-Prince, Haiti.” PLoS ONE 10, no. 5. https://doi​ However, microfinance solutions for sanitation or housing are still .org/10.1371/journal.pone.0125336. limited in many countries, particularly those where borrowing costs are deemed high. Sanitation Safety Planning: A Manual for Safe Use of Wastewater, 5 This feedback was gathered through focus group discussions with Excreta and Greywater in Agriculture. 2015. Geneva: World Health customers and based on satisfaction surveys carried out by the CBS Organization. http://www.who.int​/water_sanitation_health​ service providers as part of their regular assessments. In Sanergy’s /publications/ssp-manual/en/. 32 Evaluating the Potential of Container-Based Sanitation C HA P T E R 4 • FINAN C IAL PE RFOR M AN CE This section analyzes the financial performance of Integrated Livelihoods (SOIL) but not for x-runner, container-based sanitation (CBS) service providers which faces regulatory constraints on selling its reuse using data from the field studies that took place in April product. For SOIL, reuse is a net cost to the overall and May 2017.1 From this, the CBS service providers operation and does not cover its production costs. ­ demonstrated a clear understanding of their businesses and cost elements, the likely evolution of their costs with In Nairobi, Sanergy’s revenues from toilet operators expansion, as well as their projected funding needs. cover a modest percentage of total costs (an estimated 18  percent as of May 2017). However, the operator is All of the CBS service providers reviewed in the case planning to reduce the subsidy requirement by con- studies are funded through a mix of user charges trolling costs and increasing scale. The Fresh Life Toilet for the toilet services, revenues from reuse activities services managed by Sanergy had total budgeted costs of (where these are undertaken), and external subsidy a little less than US$1.5 million for 2017, with 11 ­percent funding. Even though they are not covering their total (a little less than US$160,000) recovered via fees from costs, all four have strived to boost revenues from operators and eight percent (close to US$130,000) the first two and reduce costs in order to reduce their from the subsidy for the excreta paid by the for-profit dependency on the latter. To that end, they have sought operation.2 Revenues from the fees charged to the toi- to improve the efficiency of their operations, in some let operators alone were a little less than US$160,000 in cases by deliberately slowing down expansion while first 2017, covering 11 percent of total costs. The for-profit focusing on improving their business models. However, operation does not currently cover all its costs, but it is according to their own projections, they will continue scaling up operations and reconfiguring its process flow to require external funding for the foreseeable future in to achieve profitability. order to remain financially afloat, as is often the case for sanitation services. Sanergy intends to demonstrate a low per capita cost through a major expansion coupled with cost-efficiency gains. It also reduces the cost of collection services with Revenues from User Charges and Reuse the market value of the treated feces as a feedstock for Product Sales Cover a Small Portion of Costs fertilizer and animal feed production. As of May 2017, Sanergy estimated that its total budget would rise to a None of the CBS service providers had been able to peak of approximately US$4.2 million by 2023, when achieve financial viability by the time of the field full market penetration is achieved, before dropping and ­studies. All received significant external support for stabilizing at approximately US$3.4 million thereafter. their activities, in the form of funds and technical assis- Revenues are projected to rise steadily to a plateau of tance, which accounted for 80 to 90 percent of their total approximately US$2.3 million, leading to 56 percent cost costs. The remaining 10 to 20 percent came in through recovery in 2023 and 69 percent from 2024 onward (due revenues, which include fees from service users (either to lower total costs). The net costs—that is, the annual final consumers or Fresh Life Toilet operators in the case subsidy requirement for the Fresh Life Toilet service— of Sanergy) and revenues from reuse. Reuse activities are projected to increase to about US$1.9  ­ million in generate revenues for Sanergy and Sustainable Organic 2018, stay between US$1.8 million and US$1.9 ­ million Evaluating the Potential of Container-Based Sanitation 33 until 2024, and then drop to a stable level of a little less Revenues from the fees charged to service users covered than US$1.1 million beyond that. However, this subsidy about 38 percent of the costs of providing the service. requirement would be spread over a much larger num- Reuse activities generated some operating costs but not ber of customers, with the goal of getting the annual corresponding revenues due to regulatory restrictions subsidy per person down to a level that can be funded on the sale of reuse products. x-runner’s operation has sustainably by the government. These levels of subsidies been funded by private and government foundations rely on assumptions about the scaling up of the reuse for as much as US$400,000 per year since its creation. product sales and the continued payment of user fees. It also benefits from toilet units purchased at a highly discounted price from Swedish manufacturer Sepa- The majority of external funding for Sanergy to date has rett. The cost of toilet units is an important component been provided by 15 family and corporate foundations because toilet purchase and installation represent the (the median contribution being US$93,000). Sanergy is most expensive part of x-runner’s operation—a little aiming to transition to funding from the government less than 20 percent of its 2016 budget. Treatment, on and international financial institutions as the scale of its the other hand, represents a relatively low portion of its operations grows and, eventually, transition to a system operations costs—about 6 percent—and does not seem that would mobilize funding from the city’s tax base.3 In to present opportunities for significant cost-­ cutting. 2017, Sanergy raised US$12.5 million for the for-profit If corresponding regulatory changes were to allow arm through a mix of debt, equity, and grants. x-runner to reuse the treated feces, it could look into generating revenue from its activities. In Haiti, according to SOIL’s own analysis, the user fee of G 200 (US$3.00)4 remains less than the cost needed In Kumasi, Clean Team is also focusing on reducing for covering the costs of containment (US$1.37), collec- costs while maintaining service performance. Clean tion (US$2.90), and transport (US$2.75). In May 2017, Team was expecting to recover 20 percent of total SOIL intended to increase the user fee though it feared costs from customers in fiscal year 2016–17 (with the customers might be unable to pay. As of May 2018, SOIL remaining 80 percent covered by external subsidies) had conducted a willingness-to-pay survey in Port-au- but is planning to increase this portion to 40 percent Prince, leading to fee increases from G 250 to G 350 with in 2017–18 and to stop subsidizing its operational an 80 percent customer retention rate and was consider- costs by October 2018. It is looking to achieve this ing how to adapt this approach in Cap-Haitien. At the through a combination of service charge increases and end of the chain, SOIL compost sales are not sufficient efficiencies. Although no reuse is currently taking cost ­ to cover processing costs: The revenue generated from place in Kumasi, the Water & Sanitation for the Urban them currently covers an estimated 20 to 40 percent of Poor (WSUP) has commissioned a study to build the operational costs at the compost site (less if taking into business case for investment in appropriate waste- account overhead costs, as noted above) (Preneta et al. to-resource solutions for all excreta produced in 2017). SOIL is reluctant to increase the sales price of Kumasi, including feces collected by Clean Team. compost, however, out of fear that most of the custom- ers would change suppliers, given that compost use is Some evidence shows that, as these services become already low despite considerable soil erosion. better known and established in their respective ser- vice areas, there is potential for recovering a higher In Lima, the total cost of x-runner’s operations in proportion of total costs via service charges. A study 2017 was US$336,458, with 18 percent (a little less for Clean Team recommended focusing on reaching than US$60,000) recovered via fees from users. the “working poor”5 (as opposed to the extreme poor) 34 Evaluating the Potential of Container-Based Sanitation to achieve higher service charges and boost gross mar- CBS service providers are already either using or gin (Ernst & Young [EY] 2017). Partly based on these looking into mobile payments to reduce the costs recommendations, Clean Team raised the price of its associated with fee collection, and some are offering services in April 2017 without a noticeable loss in the discounts to customers who adopt such a payment number of customers. Clean Team increased prices method. In Kenya, Sanergy has been using M-Pesa as by  8.5 percent for mobile payment subscribers and a mobile payment platform, given its widespread use in 23 percent for cash payment subscribers. This dou- the country. However, in countries where mobile pay- bled as a way to encourage people to adopt the mobile ments are less widespread, such as Haiti, this can be more payment option, which enables Clean Team to save on difficult to achieve and requires specific communication operating costs. campaigns. SOIL has put in place several strategies to increase mobile payment uptake with successful results: Mobile payment rates have reached 30 percent in Cap- CBS Service Providers Deploy a Mix of Haitien and 65 percent in Port-au-Prince as of May 2018. Strategies to Reduce Costs Expansion and network densification is also seen as The CBS service providers reviewed as part of the a key way to achieve economies of scale and reduce study are managed as businesses and deploy a mix of costs. Most CBS service providers have identified poten- strategies to reduce costs, including: tial areas for expansion and have ambitious plans for • Improving efficiency to reduce the main cost drivers; increasing their customer bases. Some have spread to different service areas: For example, SOIL started offer- • Expanding the customer base to achieve economies ing a paid service in Cap-Haitien in 2013 (prior to this, of scale and spread fixed costs over a larger basis; it was experimental and free) and expanded into Haiti’s and capital, Port-au-Prince, in 2015. Although the opera- • Generating additional revenues (mostly from reuse tion there is still comparatively smaller than the one in activities) to cross-subsidize the loss-making toilet Cap-Haitien, SOIL is anticipating a substantial share services. of its planned growth to come from there. To achieve Sanergy, for example, maintains a close focus on oper- that, it is planning to hand over part(s) of the service ational efficiency and the elimination of idle capacity, chain to private enterprise(s), such as the local collec- including in its toilet manufacturing facility, transport tion and transportation from the transfer points to the network, and excreta composting facility. Densifica- treatment sites. tion of the customer base is a key strategy it deploys to reduce the time needed for excreta collection so that Since 2016, x-runner started outsourcing transportation those involved in collection can also work on consoli- to the waste disposal site to a national waste manage- dating the feces into larger drums for final transport to ment company, EcoCentury, which has all the regulatory the treatment site. approvals necessary to function as a sanitation service provider (which x-runner does not yet have). This has Clean Team has been working with WSUP and Ernst & significantly reduced the logistical and regulatory risks Young (EY) to identify ways to boost its gross margin. It for x-runner’s collection services and has improved its made changes to the toilet technology (switching from operations. x-runner is focusing on gaining new cus- wet to dry toilets and using sawdust as a cover material), tomers by applying a range of marketing techniques, reduced the frequency of collections, and promoted a including specific discounts for communities where switch to mobile payments. 50 percent or more of the households use its services Evaluating the Potential of Container-Based Sanitation 35 and promote its services through female ambassadors. Not all of the CBS service providers reviewed are x-runner is also unique in that members of the house- monetizing reuse activities. Clean Team transfers the holds themselves carry their sealed buckets of feces to the feces to the Kumasi septage treatment plant, where it collection truck as it passes through the area. When cus- has access to space for disposing of the material on non-­ tomers cannot be at the collection point at the scheduled engineered drying beds. x-runner treats the feces using time, they can leave their full buckets in a custom-made a bokashi anaerobic composting system followed by a locker, installed by x-runner, at a centrally accessible two-week aerobic windrow composting process. This point when leaving home. The hygienic safety of such an overall process allows it to reduce the amount of land approach would need to be thoroughly investigated but, needed for the final disposal of the treated feces but gen- if deemed appropriate, could be extended to other CBS erates costs with no corresponding revenue source. service providers to cut excreta collection costs. More Reliable Sources of Subsidies Will Revenues from Reuse Are Also Seen by Some Likely Be Required to Sustain the Operations of the CBS Service Providers as a Way to Reduce the External Funding Requirement None of the CBS operators reviewed have yet obtained cash subsidy funding from domestic public funders in None of the CBS service providers reviewed have yet the countries where they work, but some are receiving been able to cover their composting costs and gener- in-kind subsidies. For example, Clean Team disposes of ate a positive margin from these activities. Sanergy has collected feces at the septage treatment facility operated been focusing on extracting revenues from reuse, which the Kumasi Metropolitan Assembly (KMA), which pro- it treats as a for-profit activity. It is able to get the high- vides an in-kind subsidy by charging only for renting est price of all the CBS service providers for its compost equipment to move the feces to the landfill rather than (US$400 per ton) and is exploring other reuse products, charging for the full cost of disposal. such as animal feed using a black soldier fly larvae (BSFL) treatment process. It charges the nonprofit for treating its Some of the CBS service providers reviewed have feces, but this charge is based on the cost of the best alter- developed strategies for bringing in sustainable native feedstock (pig manure) and does not cover the col- ­ subsidies—including from local authorities—but so lection and treatment costs of the overall service chain. far with limited success. For example, Sanergy is look- This means that the for-profit in effect cross-subsidizes ­ airobi ing for ways to enter into a pilot in which the N the nonprofit managing the toilet services. In 2017, how- County government would subsidize services to a small ever, Sanergy’s revenues from composting were equiva- number of beneficiaries. SOIL has been in discussions lent to 40 percent of the costs of treating the feces, not with the Haitian government, the World Bank, and including sales, marketing, and distribution. the Inter-American Development Bank for several months about developing innovative public financing In Haiti, SOIL also produces compost, which it sells for transportation, treatment, and composting through at US$280 per ton to agricultural companies, founda- a “payment for results” mechanism or a social impact tions, nongovernmental organizations (NGOs), and bond. This would result in financing being leveraged private individuals. However, as mentioned above, the from development banks, subsidies being disbursed by price it gets for the compost does not fully cover the the Haitian government, and services being implemented costs of the compost plant, which means that the possi- by SOIL or a private company. In this proposed scheme, bility of cross-subsidizing the toilet activities has so far the volume of compost produced would be used as a key proved elusive. performance indicator and payment trigger. In  2017, 36 Evaluating the Potential of Container-Based Sanitation Sanergy used the fact that it runs a for-profit operation referred to as “Fresh Life Initiative,” rolls out a public toilet ser- vice by setting up toilet business franchises. The for-profit entity, for part of the service chain to secure financing through “Sanergy,” provides excreta management services to the nonprofit arm and produces branded fertilizer and animal feed that incorpo- debt (US$5 million) and equity (US$5 million from four rate feces as a core feedstock. investors). It also secured grant funding from the Bill & 3 As of May 2018, and despite significant efforts, this system had not yet materialized. Melinda Gates Foundation. The other CBS service pro- 4 The user’s fee of G 200 corresponded in 2014 to US$5 and a little viders could explore similar financing mechanisms to more than US$3 in June 2017. further bridge the gap between their revenues and costs. 5 EY (2017) defined the working poor in this situation as “customers who have a steady income, somewhere in the range of US$50 to US$150 a month, but who are nonetheless not wealthy enough to install their own septic tank or sewer-connected toilet, or who live in circumstances where these are impractical.” Notes 1 As Clean Team had completed an in-depth financial analysis in May 2017 with the support of EY and in collaboration with WSUP, it did not References want to duplicate these efforts. The financial analysis for Clean Team is, therefore, based primarily based on the EY–WSUP report, which had EY (Ernst & Young) and WSUP (Water & Sanitation for the been conducted to advise Clean Team on pathways toward achieving Urban Poor). 2017. The World Can’t Wait for Sewers: Advancing financial sustainability and reduce dependency on external funders. Container-Based Sanitation Businesses as a Viable Answer to the 2 The for-profit cross-subsidizes the nonprofit CBS toilet service by Global Sanitation Crisis. London, UK. providing free treatment of the excreta and paying a “fair” market rate for it as a composting feedstock. The cost (to the for-profit) of Preneta, N., B. Mesa, S. Kramer, and C. Remington. 2017. collection between January and April 2017 was between US$0.06 “Thermophilic Composting as an Effective Waste Treatment and US$0.07 per kilogram of feces, roughly double the amount Option in Low-Resource Settings.” Poster presentation. FSM4 charged to the nonprofit (hence the subsidy). The nonprofit entity, Conference, Chennai, India. Evaluating the Potential of Container-Based Sanitation 37  M E RGING LESSONS AND ARE AS C HA P T E R 5 • E FOR FUTUR E WOR K This review of the four container-based sanitation (CBS) • The ground conditions are not suitable for the case studies has generated emerging lessons for gov- installation of latrine pits, septic tanks, or sewers ernments and external funders and has helped identify (for example, flood plains); a number of areas for future work, which should be • Landlords are not willing to invest in toilets; undertaken as CBS approaches begin to scale up around • Water shortages make sewer-based solutions more the world. challenging; • The majority of households do not lie on roads or Emerging Lessons paths that are large enough or otherwise suitable for the installation of sewers (including simplified/­ CBS approaches should be considered as part of a menu narrow diameter sewers, though these can be of citywide inclusive sanitation (CWIS) options. The spe- installed in very dense slums with minimal access cific planning and rollout of CBS services will vary based ways) or are not accessible for proper fecal sludge on location but, as is the case for other CWIS approaches, management (FSM) access and collection; or it should be articulated closely with urban planning and • Existing sanitation planning does not foresee the development priorities. One option could be to iden- rollout of more conventional sanitation services in tify geographical areas where CBS approaches would be the short to medium term. most  appropriate—or would be the best fit, given local conditions—and support their development accordingly. Some CBS service providers (such as Sanivation in The introduction of CBS services could be consid- Kenya) have also started expanding in refugee camps, ered especially for poor urban populations for whom where such solutions can be particularly well-suited as alternative on-site or sewer-based sanitation services the CBS units are rapidly movable and can be deployed— might not be appropriate. These include dense slums and redeployed—quickly to meet unplanned influxes and areas that are flood-prone or hard to reach (such of people. as hilly terrains or settlements above or very near to water courses). CBS services can also be considered for Adopting a conducive policy and regulatory environ- areas where: ment could be an important first step for governments looking to foster CBS services in areas where they • The housing density and/or the size of the living could be suitable. Regulation of CBS and FSM services quarters prevent the construction of pits or sep- would ideally be done in conjunction in order to regu- tic tanks or the laying of sewers and most of the late public health and environmental aspects up to the population lives far (that is, more than 50 meters) point where the pathogen and nutrient parameters meet from existing shared toilets, which means that some the national/local standards for discharge to a water people, notably women and girls, do not have safe body, disposal to a landfill, or transformation into a access at night and disabled people might not have reuse product. This would include clear procedures for access at all;1 operators in the emptying and transportation processes 38 Evaluating the Potential of Container-Based Sanitation to ensure that all CBS and FSM service providers are The customer-oriented nature of CBS services means held to the same standards in mitigating potential that the providers offer a way for new customers to begin health and pollution risks. Regulatory oversight should accepting to pay for sanitation services and to practice also ensure that the CBS service providers adequately better household hygiene which, in turn, is more widely monitor the operation and management of CBS toilets beneficial. As and when other sanitation solutions are by customers and react swiftly and appropriately where rolled out in the future, forerunner CBS services can hygiene is substandard. fill more than a temporary access gap as they also build the mindsets of customers who subsequently value san- Where it does not exist, a regulatory framework should be itation services and who are used to interacting in a developed for the reuse of treated feces/excreta, including responsible way with service providers. for agricultural and other uses, which have sometimes been limited by health concerns—such regulation would serve for both CBS and other FSM services. The develop- Areas for Further Analysis ment of overall service standards could enable broader Although this report indicates that CBS can effectively replication of CBS service models and benchmarking of provide safely managed sanitation in urban areas, there service quality, thus promoting consistency and further are currently a small number of operators providing CBS confidence in the CBS approach. It would also provide services in different parts of the world, each at a rela- a level playing field to allow for the development of CBS tively limited scale. As these existing CBS operators scale approaches alongside other sanitation services, especially up their services, it will be important to continue car- on-site sanitation (OSS) and FSM. A better definition of rying out operational research to explore the following the institutional framework required for developing and questions, among others: monitoring standards could help improve the safety of services and overall service quality. • What constitutes a safe CBS service, and what are its essential features? Can a broadly accepted defini- Recognizing that CBS service providers will likely not tion of “safe CBS services” be developed to provide be covering their full costs in the short term—and that the basis for their inclusion as part of the improved most urban sanitation services around the world are sanitation options for achieving sustainable devel- subsidized to one degree or another (be it subsidies opment goal (SDG) 6?2 for their capital costs or their running costs)—­ public • How can CBS services be integrated within a broader authorities and/or water supply and sanitation (WSS) menu of options for WSS and CWIS service provi- service providers could explore ways to ensure that sion so as to facilitate service integration, promote CBS services are sustainably financed. Examples services to the poor, and encourage cost recovery? include cross-subsidies from services provided in more affluent service areas, including other types of sanitation • What management models can be considered to provision and other related services (for example, water ensure the safe provision of CBS services, ranging supply or solid waste management) or direct subsidies from dedicated CBS service providers to the incor- from public sources. In situations where governments poration of CBS as part of a menu of options pro- contract CBS service providers for service delivery in vided by larger utilities? specific areas, such arrangements could be structured as • How do CBS approaches compare financially and performance-based contracts so as to introduce incen- economically to other available sanitation alterna- tives for greater efficiency, cost reductions, and greater tives in the cities where CBS service providers cur- accountability. rently operate or could potentially enter? Evaluating the Potential of Container-Based Sanitation 39 • How can existing CBS service providers be sup- References ported to scale up service provision in existing Banerjee, S. G., and E. Morella. 2011. Africa’s Water and Sanitation service areas or to expand into new areas, where Infrastructure: Access, Affordability, and Alternatives. Directions in applicable? Development; Infrastructure. Washington, DC: World Bank. • How could performance-based contracts be Government of Peru. 2014. National Investment Plan for the Water and Sanitation Sector (Plan de Inversiones del Sector Saneamiento de Alcance designed for CBS services? What could be suitable Nacional 2014–2021). Japan International Cooperation Agency. service standards and “payment triggers” as a part Graf, J., O. Kayser, and S. Brossard. 2014. Designing the Next of results-based financing arrangements? Generation of Sanitation Businesses: A Report by Hystra for the Toilet Board Coalition. Sponsored by AFD, UKAid, Kimberly-Clark, the Stone Family Foundation and Unilever. London, UK. Mujica, A., and Z. S. Uriarte. 2016. Fecal Sludge Management: Notes Diagnostics for Service Delivery in Urban Areas. Case Study in Lima, Peru. Water and sanitation program (WSP); Water and sanitation program technical paper. Washington, D.C. : World Bank Group. 1 C.f. SGD 6.2: By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying Platzer, C., H. Hoffman, and E. Ticona. 2008. “Alternatives to special attention to the needs of women and girls and those in Waterborne Sanitation—A Comparative Study: Limits and Potentials.” ­vulnerable situations. Presented at the IRC Symposium: Sanitation for the Urban Poor Partnerships and Governance, Delft, The Netherlands. 2 In the SDG 6.2 definition and according to the Joint Monitoring Programme (JMP), “Improved sanitation facilities are those Rao, K. C., E. Kvarnstrom, L. Di Mario, and P. Drechsel. 2016. designed to hygienically separate excreta from human contact.” Business Models for Fecal Sludge Management. Colombo, Sri Lanka: (JMP 2018) Defining a safe CBS service could ensure that the solu- International Water Management Institute (IWMI). CGIAR Research tion is counted among those improved sanitation facilities in SDG Program on Water, Land and Ecosystems (WLE). Resource Recovery monitoring. and Reuse Series, no. 6: 80. doi:10.5337/2016.213. 40 Evaluating the Potential of Container-Based Sanitation A P P E NDI X A • PE O P L E INT E RVIE W E D SOIL discussions were organized: one in the Saint Michel area with nine participants and two in the Aviation area with Focus group discussions: With the support of local five participants each. All groups were mixed by gender. organizations working with Sustainable Organic Discussion topics included customers’ motivations to Integrated Livelihoods (SOIL)—to balance logistical sign up for the service, existing alternatives, customer issues with potential bias of answers—three focus group satisfaction, and affordability. Key Informants Organization Position Name Direction Nationale de l’Eau Potable et DINEPA director of sanitation Edwige Petit de l’Assainissement (National Directorate of Water and Sanitation ; DINEPA) Office Règional d’Eau et Responsible OREPA OUEST Raphael Hosty d’Assainissement (OREPA) DINEPA Cap-Haitien Eng. Gustave DINEPA SOIL board member, previous director Ingrid Henry for sanitation, DINEPA Ministry Environment Cadre de Vie et Assainissement director Dr. Evans Louis Ministry Public Health and Population Promotion de Santé et de la Protection Dr. Jocelyne Pierre Louis de l’Environnement director GRET Program coordinator Caroline Benard Municipality Limonade Responsible urban planning direction Name not available Municipality Cap-Haitien General director Frantzy Jean CBO ADF (Fosenmichel (Cap-Haitien) Several CBOs ADF representatives Names not available Community Based Organization Several CBOs representatives Names not available OCDEL/MPBK (Cap-Haitien) Place Cazeau (Port-au-Prince) Several CBOs representatives Names not available table continues next page Evaluating the Potential of Container-Based Sanitation 41 Organization Position Name CBO Sakala; Cité Soleil (Port-au-Prince) CBOs leader Daniel Tillias Center for Investments Former staff Ivy Kuperberg Independent consultant Anthony Kilbride Independent consultant Pierre Yves Rochat Jedco Cap-Haitien local director Name not available Manual emptier Business owner (informal) Name not available SOIL Bloc coordinator, Fosenmichel Yvrose Pailleur SOIL Payment collector, Fosenmichel Junior Bonhomme SOIL Responsible depot, Fosenmichel Pierre Reginald SOIL Bloc manager, Avyasyon Algate Joseph SOIL Compost site operator, Cap-Haitien Markindy Etienne SOIL Compost director, Cap-Haitien Job Etienne SOIL EkoLakay director, Cap-Haitien Erinold Frederic SOIL Regional director, Cap-Haitien Romel Toussaint SOIL Collector (daily worker) Benik Nordeus SOIL EkoLakay adviser Claire Remington SOIL EkoLakay director, Port-au-Prince Herby Sanon SOIL Compost director, Port-au-Prince Jean Marie Noel SOIL Regional director, Port-au-Prince Baudeler Magloire SOIL Executive director Sasha Kramer Satisfaction survey: The 2018 “Customer Satisfaction (representing 33 percent of customers at that time) and with the EkoLakay Household Toilet Service, Northern 88 customers in the Port-au-Prince service area (repre- Haiti, and Port-au-Prince” survey sampled 281 cus- senting 52 percent of customers at that time). tomers in the EkoLakay service area in Northern Haiti 42 Evaluating the Potential of Container-Based Sanitation x-runner Key Informants Organization Designation Name x-runner Chairperson Isabel Medem x-runner Chief executive officer Raúl Briceño x-runner Chief financial officer Mónica Ramos x-runner Chief operating officer Maria Pia Quiroz x-runner Customer relationship manager Natalia Benavides x-runner Head of installations Celi Sedano x-runner Head of sales Esther Calderón x-runner Waste treatment plant manager Nemecio Cóndor World Bank Lima Office Water and sanitation specialist Malva Rosa Baskovich Via San Juan Community leader Rogelio Servicio de Alcantarillado y Agua Potable Head of Investigations, Innovation, Oswaldo Hernán de Lima (Lima Sewerage and Water Supply Standardization Team and ­ Vargas Cuellar Services; SEDAPAL) Ministry of Housing, Construction and Sanitation National sanitation director Oscar Pastor Superintendencia Nacional de Servicios de Tariff Regulation Management Ana Vergara Saneamiento (National Superintendence of Supervisor II Sanitation Services; SUNASS) SUNASS Tariff Regulation Management Luis Acosta SUNASS Tariff Regulation Management Arturo Lázaro SUNASS Tariff Regulation Management Gretelina Castañeda Grand Challenges Canada Consultant Alyse Schrecongost Evaluating the Potential of Container-Based Sanitation 43 Sanergy • One school with Sanergy toilets, operational for fewer than six months Focus group discussions: Two schools were selected, • One school with Sanergy toilets, operational for and short focus group discussions were conducted at more than 12 months each with a group of five girls and a group of five boys. For each of the first four categories, one male and one Toilet facility data: Locations, opening dates, and the female operator were selected, though interviews were type of service model was obtained from Sanergy and often with the husband, wife, daughter, co-operator, or plotted against a Nairobi road map in QGIS. Purposive employee of the registered Fresh Life Operator (FLO). sampling was then used to select toilets with the follow- This way, in the end, six of the interviewees were female ing characteristics: and two were male. The FLOs were operating between one and three toilets each. The period of time that these FLOs • Two “new” commercial toilet operators, operational had been operating the toilets did not have any noticeable for fewer than six months impact on their level of satisfaction or responses in general. • Two “old” commercial toilet operators, operational for more than 12 months While visiting an FLO, users leaving the toilets were • Two “new” residential toilet operators, operational asked if they were willing to be interviewed. The consul- for fewer than six months tants identified the users, and the FLO would make the • Two “old” residential toilet operators, operational request. Many were busy during the workday, and only for more than 12 months five were interviewed. Key Informants Organization Position Name Sanergy Co-founder/director David Auerbach Sanergy Co-founder/director Lindsay Stradley Sanergy Co-founder/director Ani Vallabhaneni Sanergy Chief financial officer Sanj Sanampudi Sanergy Customer support manager Joseph Githinji Sanergy Fresh Life chief operating officer Titus Kuria Sanergy Fresh Life services manager Eric Machango Sanergy Government relations manager Alex Manyasi Sanergy Head of operations Michael Lwoyelo Sanergy Residential customer support assistant manager Florence Mwikali Sanergy Commercial customer support assistant manager Peter Khaemba table continues next page 44 Evaluating the Potential of Container-Based Sanitation Organization Position Name Sanergy Schools customer support assistant manager Polycarp Sifuna Sanergy Treatment site manager Kennedy Okwany Nairobi City County Public Health deputy director Jairus Musumba Nairobi City County Water and Sanitation director Kainga Mario Ministry of Health Public Health director Kepha Ombacho Ministry of Water and Irrigation Sanitation director Rose Ngure National Environment Compliance and enforcement officer Maurine Njeri Management Authority Imara Daima location Assistant chief Mark Nyasera Mukuru Kwa Njenga location Senior chief Jonathan Musila Shauri Moyo location Assistant chief Hezekiah Obongita Shauri Moyo location Chief Florence Mbwika Land Mawe (Kayaba) location Chief Solomon Muragori Goeta School, Mukuru Teacher James Mutonga Goeta School, Mukuru Boys’ focus group (five, from classes 4–7) Anonymous Goeta School, Mukuru Girls’ focus group (five, from classes 4–7) Anonymous Pilot School, Mathare Head teacher Aloyss Oyoma Pilot School, Mathare Boys’ focus group (five, from classes 6–8) Anonymous Pilot School, Mathare Girls’ focus group (five, from classes 6–8) Anonymous FLOs FLOs (eight: three residential, three commercial, Anonymous two hybrid) Community Fresh Life users (five) and non-users (one) Anonymous Bill & Melinda Gates Foundation Demand-Led Sanitation senior program officer Jan Willem Rosenboom World Bank Kenya Office Senior water and sanitation specialist Chris Heymans World Bank Kenya Office Operations analyst Lewnida Sara Osprey Foundation Managing director Louis Boorstin Vitol Foundation Head of Water, Sanitation, and Hygiene Regis Garandeau Vitol Foundation Board member Richard Carter Evaluating the Potential of Container-Based Sanitation 45 Clean Team Key Informants Organization Position Name World Bank Ghana Water supply, sanitation, and hygiene Emmanuel Nkrumah (WASH) advisers Sanitation/Environmental Health and Program Officer Kweku Quensah Sanitation Directorate (EHSD) Kumasi Metropolitan Assembly (KMA) Waste Management Department director John Gorkeh-Miah KMA EHSD director Don Awantungo Greater Accra Metropolitan Area (GAMA) Waste Management Department director Anthony Mensah Water & Sanitation for the Urban Poor Head of sanitation Georges Mikhael (WSUP) WSUP Ghana Social business lead Faustina Ashante Public toilets Owner Name not available Sewerage network Operator Name not available Manual emptier Drivers Names not available Clean Team Chief executive officer Peter Townsley Clean Team Head of operations Abigail Aruna Clean Team Sales manager Eric Yeboah Clean Team Finance officer Name not available Clean Team Account manager, Asawase Janet Harrison Clean Team Account manager, Adukrom Lovia Boakye Clean Team Account manager, Sabon Zongo Beatrice Agyemang Clean Team Account manager, Tafo Name not available Clean Team Sales officer Names not available Clean Team Collector, Asawase Alidjah Aygiya community Traditional leader Name not available Aygiya community Traditional leader Name not available Interviews were also organized with 14 customers from Asawase and Tafo and five noncustomers from Oforikrom and Asawase. 46 Evaluating the Potential of Container-Based Sanitation W18038