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Turning Human Waste Into Human Welfare (The Daily Beast)

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(Via The Daily Beast)

NAIROBI, KENYA – About half of Nairobi’s 3.3 million people don’t have access to piped water or a sewage grid. Put simply: this is a public health catastrophe that disproportionately harms women and children. Water and sanitation development projects are legion in the informal settlements of Nairobi, and yet the basics of sanitation—access, affordability, and cleanliness—barely exist.

Sanergy, a for-profit/non-profit hybrid started by five MIT students in 2011, may change that. It manufactures and distributes toilets designed specifically for dense, urban informal settlements, then collects the resulting waste and processes it into high-value byproducts like fertilizer, which can be sold to local farmers. Its model has the potential to sustainably improve sanitation in dense, urban areas unequipped with a proper sewage grid.

“There’s still not a clear answer for how you actually build a sustainable sanitation network in urban slums,” Lindsay Stradley, one of Sanergy’s five co-founders, told me in an interview at its office in Mukuru Kwa Ruben, an informal settlement a few kilometers south of Nairobi’s central business district. One question in particular drew the team in, she said: “How do you harness the waste that comes out of sanitation—and now is a huge cost center—and turn that into a source of revenue to sustain not just the operations but potentially a whole community?”

In other words: how do you turn human waste into human welfare?

With a proper, piped sewage grid, this is relatively straightforward: waste is channeled to a central location where it can be sorted, disinfected, and treated with microorganisms, then sold as a high-value byproduct like fertilizer or biogas. New York City’s 6,000 miles of pipes, for example, move 1.3 billion pounds of wastewater to 14 treatment plants each day, resulting in 2.4 million pounds of “biosolids.” Some is sold as a liming agent, and some is disposed of in landfills (though it used to be sent to Colorado to fertilize crops).

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Without a sewage grid, waste collection would need to be sanitary, simple, and efficient—an impossible ask of traditional pit latrines. Waste must be periodically removed from the pit, which most often involves modern-day night-soil men who bale it out, bucket by bucket.

Sanergy designed a toilet to allow quick, clean waste removal. Rather than using a pit, the toilet has two blue modular plastic jugs that collect waste during the day, and are efficiently removed and replaced with clean ones each evening by its logistics team.

To install its “Fresh Life Toilets” in communities, Sanergy employs a microfranchising model, allowing entrepreneurs to purchase and run the toilets as independent businesses. Fresh Life Operators, or FLOs (Sanergy’s term for its microfranchisees) receive advising, discounts on sanitary products, and other forms of support from the organization, but otherwise “they own it, they operate it, [and] their success is their own,” Stradley said.

FLOs purchase Fresh Life Toilets for 50,000 Kenyan shillings (about $580—the manufacturing cost), and can buy additional toilets at a discount. Unfortunately, many prospective FLOs don’t have that kind of money, and accessing credit can be very difficult for the chronically unbanked settlement population. This was a significant challenge to Sanergy’s model until it partnered with Kiva in September 2012. Since then, dozens of FLOs have received loans to purchase toilets.

The toilet was designed to have a very small footprint—just three feet by five feet—so it fits on an individual’s plot of land. After manufacturing pre-fabricated components at its headquarters, Sanergy engineers install a toilet on the FLO’s land, and it is immediately ready for use.

Currently, there are 365 Fresh Life Toilets in Mukuru Kwa Ruben and other settlements, owned by 190 FLOs. The toilets provide hygienic sanitation to about 15,000 residents each day, and 2,050 tons of waste has been collected in the past two years.

Simon Stumpf, a Regional Representative for Ashoka East Africa, which elected co-founder David Auerbach as an Ashoka Fellow in 2013, told me in an email interview that Sanergy’s model

“may not sound that innovative at first, but this is the key Sanergy insight. It has to be all three: Affordable. Accessible. AND hygienic… they are proving that ‘good enough’ isn’t good enough anymore.”

Other solutions manage to hit one or two of these needs, but Sanergy is unique in its ability to achieve all three at once. One popular alternative model is a “sanitation block”: a large structure that houses multiple toilets and often includes hot showers. Some sanitation blocks, like the “bio-centers” constructed by Umande Trust, even generate biogas from the waste. But these blocks are large by definition and by necessity, so finding space for them in cramped, congested informal settlements is an issue, as sanitation block-builder Maji na Ufanisi (Water and Development) has found. The blocks are also quite expensive at $30,000 each.

Most importantly, access is still a problem for those that live far from a block. If you don’t solve the access problem, you don’t solve the sanitation problem. The small footprint of Sanergy’s toilet allows for it to be placed just about anywhere, which allows for more efficient allocation of toilet supply.

Typical pit latrines are often inaccessible and unclean. Pit latrine operators simply don’t have the inherent incentive to keep them clean; sanitation is an added expense, and owners have a captive market. As a mission-oriented organization, Sanergy cares about offering hygiene and a clean environment for customers. When FLOs purchase a toilet, they agree to keep it well-stocked with sanitary products like toilet paper and soap. If they don’t, a Sanergy employee will work with them to fix the problem.

Typical pit latrines in Mukuru Kwa Ruben

Typical pit latrines in Mukuru Kwa Ruben

Alex Wekesa, a 26-year old employee of Sanergy, also owns two Fresh Life Toilets near his home in Mukuru Kwa Ruben (it’s not uncommon for Sanergy employees to also be FLOs). Before working at Sanergy, Alex did what many residents of informal settlements do: he strung together an array of side jobs—barber, driver, launderer—to make ends meet. Unlike many of his neighbors, though, he completed university, which allowed him to get a more stable job. He used his savings to become a FLO.

As we were walking through the congested, uneven, dirt streets, narrowly dodging the schoolchildren running around after school, I asked Alex why he decided to become a FLO. “The sanitation in my area is very bad,” he said simply. “And the pay helps me to pay for my brother’s schooling.” In return, his brother is his employee, operating the toilets while he is away.

A long, narrow alleyway lined with corrugated aluminum homes led to Alex’s two immaculately clean toilets. He charges four shillings per adult use (about $.05) and two shillings per child use (market rates in the area), but was quick to point out, “if someone doesn’t have the cash, I let them use the toilet and they can pay back later.”

Alex‘s location is perfect for the toilets—a main thoroughfare with lots of foot traffic—so he didn’t have an issue attracting customers. He had so many, actually, that it made sense to purchase another Fresh Life Toilet, and now about 100 customers visit his toilets each day.

Alex pays an annual leasing fee, and must commit to keeping the toilets clean and well-stocked with soap and other sanitation products, but otherwise is free to run his business as he sees fit.

Other FLOs have had more trouble than Alex. Some simply haven’t had enough demand, and others have managed their toilet or their money poorly, and have defaulted on their Kiva loans. To prevent defaults and failures, Sanergy carries out extensive market research ahead of entering a new neighborhood, and the model itself works against failure: because the FLOs are in business for themselves, they are incented to do well.

After collecting the waste, Sanergy’s logistics team brings it to a central processing facility in Mukuru Kwa Ruben, where it is weighed and placed in large bins. It is monitored, tested, and treated, and becomes fertilizer after about eight months. The most pressing question is whether Sanergy’s fertilizer, which is up to the safety standards of the Kenya Bureau of Standards and the World Health Organization, will be competitive on the Kenyan marketplace.

Waste slowly turning into fertilizer at Sanergy's production facilities in Mukuru Kwa Ruben

Waste slowly turning into fertilizer at Sanergy’s production facilities in Mukuru Kwa Ruben

 

Many external individuals and organizations are optimistic about its chances. Sanergy has racked up accolades, awards, and investment for its model; it was even the first recipient of the WASH for Life Award, a $100,000 grant given byUSAID’s Development Innovation Ventures in partnership with the Bill & Melinda Gates Foundation. These grants and private investments have allowed Sanergy to build up its network of toilets and to experiment with its fertilizer production, but for it to be financially sustainable it will need to sell a quality product. Initial testing of the fertilizer was positive; the Sanergy plot yielded 30% more sorghum than a non-fertilized plot. While Sanergy’s fertilizer has not yet been tested against other fertilizers, the organization believes that it will be competitive with organic fertilizer on the Kenyan market.

There’s a deep potential market for fertilizer in Kenya. On average, the country’s farmers use only 35 kilograms of fertilizer per hectare of arable land—higher than the region’s average, but a fraction of what is used in other developing countries. It is highly likely that using fertilizer would increase yields and incomes, and while under-use stems from disparate causes, behavioral economists have found strategies that significantly increased its use.

In order to guarantee consistent supply for its customers, Sanergy needs to grow its network of toilets and its capacity “by three or four times,” Auerbach said recently. But scaling presents new challenges. Most visibly, it needs somewhere to put all of the waste. The current fertilizer production process is “hugely space-intensive… as we grow, it’s becoming completely not feasible” Stradley told me.

A recently-purchased machine can cut the treatment period from eight months to one week, which should reduce the amount of space needed and help the organization ensure a consistent supply of fertilizer for its customers.

As the density of toilets increases in Mukuru Kwa Ruben and the other nearby settlements, it will also need to expand, which will, at a minimum, force the logistics team to go longer distances to collect the waste, and could require additional processing facilities. This isn’t an immediate concern—there is a lot of room to grow in its current locations—but it will be a challenge in the future.

This year, it will begin to sell its fertilizer to farmers, and aims to have 1,000 toilets in use by the end of 2015.

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Thursday Links

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Saturday Links

  • “The role of the Surgeon General is not legislative, but one of advocacy. In view of the existing empirical and scientific evidence, advocating for stronger gun control is a logical and justifiable conclusion.” – this, from The Lancet, is excellent. Dr. Vivek Murthy should be confirmed, and this shouldn’t be an issue. The only silver lining from this is that it’s increasingly clear that the NRA will eventually just flame itself out by refusing to compromise; some other more reasonable advocacy group will supplant it (in a normative world, anyway)
  • Philip Klein is right: get rid of the mortgage interest deduction! He and I come at the issue from different premises and stated preferences, but the conclusion is the same: it’s a regressive, dumb, wasteful policy
  • I viewed this headline with a lot of skepticism before I read the article, and it totally changed my mind
  • Terrifying quotes from a Kenyan counterterrorism official: ”In this work you can’t go by the book.” “What do you do if no one gives you evidence?” he asked, then answering himself, “This is why there is Guantanamo Bay.” A constant reminder of how bad US ripples around the world
  • Complain all you want about the new FiveThirtyEight, but it’s analyzing decisions, admitting failure, and iterating – exactly what a nascent startup should be doing. Give it time
  • It’s laudable that policy experts are attempting to come up with ways to reduce R&D costs for the next generation of needed pharmaceuticals, but I think Uwe Reinhardt’s ever-so-slight pessimism is more on the mark: there won’t be an easy out to our cost issues, and our society – my generation – will be forced to make difficult decisions with trade-offs
  • Yes, rape culture is real
  • This is gross. Actually, it’s worse; it’s dangerous and irresponsible of Uber to allow drivers access to personal information of the riders
  • This is a long pull-quote but you should really read the whole thing:

    On my end, I’ve learned that there are times that I need to modify my own priorities and figure out with the patient what goals are achievable, at least at a given time. I’m also reminded how much more intriguing and challenging medicine is when we have the opportunity to delve in deep with a patient.

    By the “quality measures” scorecard, this patient will count as a failure on my watch, since I have not succeeded in normalizing his glucose — or his cholesterol or his blood pressure, for that matter. The objective, outcome-driven data would rate me as a better-quality doctor if diabetes fell off his radar again and he dropped out of my practice.

    Luckily for both of us, he continues to come to his appointments, and we both call that a success.

     

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Friday Links

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Wednesday Links

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Saturday Links

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Wednesday Links

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Sunday Links

  • “The good news, however, is that across the developing world, tens of millions of parents are refusing to accept that their kids sit in class day after day learning nothing. Instead, they’re moving their children to private schools. And these aren’t just wealthy parents. Extremely poor mothers and fathers are taking some of their limited income and using it to ensure that their kids can have a better life through higher-quality education” – from a nice, quick overview on private education in developing countries by Charles Kenny
  • How to make a workplace more diverse (hint: it’s harder than it sounds)
  • I think Chris Blattman gets to the core of the cash transfers debate here: no, the results aren’t, on net, as world-changing as supporters claim. But, like he and Paul Niehaus (one of the GiveDirectly founders) says, it’s the index fund of aid: the burden of proof is on the other organizations to prove they’re more “effective” (however it’s measured)
  • Checklists aren’t important in and of themselves. Their value has to be bought by all users, and if it isn’t, idly checking a box isn’t going to change anything. Atul Gawande makes a similar point at TIE: “My suspicion is that a government mandate without a serious effort to change the culture and practice of surgical teams results in limited change and weak, if any, reduction in mortality. But it’s hard to know from the Ontario study. Without measuring actual compliance with using the checklist, it’s like running a drug trial without knowing if the patients actually took the drug. Perhaps, however, this study will prompt greater attention to a fundamentally important question for health care reform broadly: how you implement an even simple change in systems that reduces errors and mortality – like a checklist. For there is one thing we know for sure: if you don’t use it, it doesn’t work.”
  • Really interesting idea, but before you wax poetic about it, remember that a) it’s a marketing stunt, basically; and b) the article doesn’t touch on costs, maintenance, etc. etc. – the boring stuff that matters a lot more than the “sexy” invention
  • If you get The New Yorker, I think you’ll enjoy The Relive Box, the fiction piece from a recent week
  • Pretty interesting interview with Bill Gates on American politics, global health, and innovation
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