Safe toilets help flush out disease in Cambodia's floating communities

Lauren Crothers

Phat Sanday is – in many ways – like any other village in Cambodia. There’s a school, a petrol station and a clinic.

However, unlike most of the other rural communities, nearly every structure here – at the southern end of Cambodia’s Tonlé Sap lake – floats. The primary mode of transport for the more than 1,100 families who live here is boat.

There is no village-wide sanitation system. Residents, whose livelihoods depend largely on fishing, defecate in the open or in latrines affixed to their floating houses, where waste is deposited directly into the water below. Everything ends up in the freshwater Tonlé Sap lake and river, which merges with the Mekong further downstream in Phnom Penh, the capital. The lake and river are a major source of income for hundreds of thousands of people.

As a result of the open defecation, diarrhoea is common, in a country where Unicef estimatesdiarrheal disease is one of the leading causes of death for children under five. And there are other health risks.

“Children have died sometimes because there is no latrine … They go around the edge of their houses to defecate – and they drown,” says Hakley Ke. He is a schoolteacher and programme coordinator with Wetlands Work, an NGO that installs sustainable wastewater treatment systems. Hakley, who has lived here since 2008, says that over the past few years concerns about sanitation have become more acute.

Taber Hand, founder and director of Wetlands Work, says the concentration of pathogens like E coli can fluctuate from about 200-400 units per 100ml of water to as much as 4,000 units per 100ml in the dry season. When the levels of pathogens are that concentrated, he says, “it’s septic”.

In 2009, he began designing the HandyPod; a simple, two-container system that filters pathogens out of wastewater. He says the version in use by nine households and a school today, priced at $125 (£100), is the most cost-effective.

The system is gravitational. With each flush – achieved by pouring a ladle of water into the toilet bowl – waste is collected in the first of two containers, where it settles and is broken down using anaerobic processes over a three-day period, and the pathogen reduction begins. The second barrel is packed with small pieces of polystyrene, which triggers a process that reduces the levels of the remaining bacteria. Each flush also forces the newly treated water back into the river, where it will pass the test for safe levels of pathogens for recreational water just one metre beyond the discharge point.

Although it will be some time before the team can ascertain the true ecological benefits, anecdotal evidence from the initial test phase – where several pods were raffled off to families – indicates the system could have a future in riparian communities in Cambodia and beyond.

Hakley works hard to spread the message about good hygiene and sanitation in his community. He says that since he installed the system in his own household, he no longer worries about something bad happening to his children, and adds that his family’s reputation in the village has improved.

He also thinks people’s attitudes towards safer toilets are changing. “The schoolgirls used to go much further away to defecate,” he says, “but now they prefer the HandyPod.”

Yun Thy, 35, has lived in Phat Sanday all her life. Until she was given a pod last year, she would defecate over the side of a boat or in the forest behind her home on the riverbank. Nights were always the worst time to have to go, she says, and a relative’s three-year-old child drowned while defecating.

 “I’m very happy that I don’t have to go in the river any more, especially at night,” she says. “It feels cleaner.”

There’s been a lot of interest in the pod from fellow villagers. Her elderly neighbours – one of whom was suffering with diarrhoea – said they would install one immediately, if they could afford it.WaterAid Cambodia has partnered with Wetlands Work to roll out the scheme. Its country representative, James Wicken, says challenges include “changing behaviour and encouraging people to pay for the toilet”, as such an investment is not usually seen as a priority. WaterAid Cambodia “is working to engage the government in water, sanitation and hygiene issues so it is prioritised at a national level”.

Hand sees the challenges with confronting tradition, but is looking forward to installing 18 more pods over the coming months in a community at the north end of the lake. “This is about dignity; about how children feel, learning and having a connection to sanitation,” he says. “The issue is human health.”