Economic Effects of Sustainable Sanitation - SuSanA

Summary
The present thesis provides an introduction to the topic of sanitation and indicates its close
links to slum settlements, malnutrition and public health. Furthermore, the issue of sustainable
sanitation as an alternative to conventional and inadequate sanitation and its economic impact
are considered. Sustainable sanitation, the underlying paradigm covered in this thesis,
considers human excreta as valuable resource rather than waste, promoting the closure of
nutrient cycles by reusing the excreta as fertiliser. At the same time sustainable sanitation
provides effective alternatives for reducing sanitation induced diseases arising from
inadequate sanitation practices. In a second step, taking into consideration the above
mentioned findings, large scale scenarios for the logistics of sustainable sanitation in urban
areas - an issue which has been identified as crucial for its successful implementation have
been designed. The geographical focus of the thesis is Sub-Sahara Africa, particularly
Kampala, the capital of Uganda. However, being based on field work conducted in this
region, the findings of this thesis can well be adapted to other developing countries in the
world.
The main findings of the thesis are summarised below: There are 2.6 billion people in the
world that lack adequate access to improved sanitation (SuSanA, 2008, p. 1). The effects of
this situation can among others be understood by taking a look at the number of people that
are affected by diarrhoea, being considered as main burden of disease of poor water,
sanitation and hygiene (cf. Prüss et al., 2002, cited in Hutton et al., 2007, p. 469). But not
enough, also the issue of undernourishment and with it the suffering of close to one billion
people is indirectly affected by sanitation due to the negative impact diarrhoea has on the
nutrient uptake efficiency. Another aspect potentially affecting the nutritional status of people
emerges when considering that common sanitation practices prevent nutrients present in
human excreta from being reused for food production. Finally, this threatening image is
intensified by considering trends of urbanisation and the dynamic emergence of slums that are
per definition, places of inadequate water supply, sanitation and hygiene (UNHABITAT,
2003a, p. 12).
Considering the diversity and impact of the above mentioned numbers and links, inadequate
sanitation can be seen as a trigger for a variety of problems, which can for instance be
expressed as number of people dying from infectious diarrhoea, decreased productivity
because of people being debilitated or forced to stay at home or environmental degradation.
Another way of presenting those effects is by introducing an economic dimension by
attributing monetary values to the individual effects, where applicable. This practice has two
main advantages. Firstly, it allows calculating the average economic burden a person suffers
from e.g. in terms of productive days lost. Secondly, it contrasts the burden that could be
averted by investments in infrastructure improvements (e.g. sustainable sanitation facilities)
with the costs of those investments by calculating benefit-cost ratios (BCR) (cf. chapter 3.2
and Hutton et al., p. 494). The results of the calculations in this thesis show that the annual
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