SOIL Haiti is Stewarding Planetary Health Through Ecological Sanitation Systems

Claire Remington
Director of Research and Innovation
Sustainable Organic Integrated Livelihoods (SOIL)

I am the Director of Research and Innovation at the organization SOIL (Sustainable Organic Integrated Livelihoods) in Haiti that provides a household sanitation service in Cap-Haitien, Haiti. Before starting in my position at SOIL, I did my master’s in civil engineering at the University of Victoria where I explored the design of sustainable sanitation systems and had the opportunity to learn more about Planetary Health. My work at SOIL and research at the University of Victoria have illuminated the deep relationship and interconnections between human health and the health of the environment.

We are experiencing a global sanitation crisis from the joint perspective of equity and sustainability. The goal of sustainable development is to meet the needs of the present without compromising the ability of future generations to do so. When we consider global sanitation from within the framework of sustainable development, we are both failing to meet the needs of the present and are jeopardizing the capacity of future generations to do so. Sasha Kramer, Co-founder and Executive Director of SOIL, started her work in Haiti as a human rights advocate where she recognized that poverty, and access to fundamental services like water and sanitation, are pervasive human rights abuses. I learned from her that safe, secure, and dignified sanitation is a fundamental human right (and it was recognized as such by the United Nations General Assembly in 2010):

“The manner in which a person is able to manage bodily functions of urination, defecation, and menstruation is at the core of human dignity.”

Despite this recognition and the work done by SOIL and countless other stakeholders, an estimated 61% of the global population, or 4.6 billion people, is without access to household-level sanitation and waste treatment where excreta is contained and treated. . About 88% of all diarrheal deaths are attributed to inadequate water, sanitation, and hygiene (WaSH) systems and diarrheal disease caused over 71 million disability-adjusted life years (i.e. estimated loss of healthy life years) in 2010. Lack of access to basic services and infrastructure, like sanitation, is associated with endemic poverty: poor sanitation increases the probability of health shocks, and poorer households (and particularly those in contexts without a social safety net) are less economically resilient such that health shocks are likely to keep households in or drive them towards poverty conditions. The inequity is one of economics, public health, poverty, and morality.

In addition to the inequity that exists between those that do and do not have access to safe, secure, and dignified sanitation systems, there is a secondary inequity that exists between those that are using unsustainable sanitation systems and future generations. Safely managed sanitation systems are defined as those household-level sanitation systems that ensure that excreta are both safely contained and treated. Safely managed sanitation systems are effective in minimizing contact between the public and the pathogens found in excreta. However, sanitation systems that are effective in protecting public health may still disrupt planetary boundaries and are thereby an unsustainable sanitation system. Rockstrom et al.’s seminal work on planetary boundaries proposes that there are nine key global subsystems that circumscribe a “safe operating space” for humanity; if we exceed the limits of key thresholds for these subsystems, we threaten irreversible environmental change. For example, conventional sewerage and wastewater treatment systems are effective in protecting public health but can discharge nutrients, micropollutants, consume freshwater, and emit greenhouse gas emissions thereby disrupting at least five of Rockstrom’s subsystems and the overall resilience of the planet and its capacity to provide for future generations.

The primary objective of sanitation is the protection of public health, but it is urgent that we consider the long-term sustainability of sanitation and waste treatment systems from the perspective of its impact on planetary system functioning. Our choice of sanitation and waste treatment systems is intimately connected to the greatest equity and sustainability challenges of our time, and we need something better.

Resource recovery has been proposed as a strategy to address these multiple social and environmental challenges simultaneously. It is estimated that current nutrient recovery from human sanitation for agriculture is between 0–15% of nitrogen and 0–55% of phosphorus, but one potential waste treatment method — the thermophilic composting of urine-diverted human waste — enables a nutrient recovery of 92% organic carbon, 100% phosphorous, and 86% nitrogen. This has dramatic implications for meeting agricultural nitrogen demand with nutrients recovered from human waste, and a case study of the city of Hamburg found that up to 29% of the synthetic fertilizer used could be substituted by the nutrients found in wastewater. Additionally, compost is like manure in that in addition to supplying critical nutrients, it also provides soil-conditioning properties, like the input of carbon substrates into soil which may immobilize nitrogen and reduce runoff and volatilization of reactive nitrogen. Recovering nutrients from sanitation could be a driver for an improved management of reactive nitrogen, with implications for improving global food security, access to sanitation, and stabilizing planetary boundaries.

SOIL’s sanitation system combines container-based sanitation with aerobic, thermophilic composting. Haiti suffers from severe soil degradation, food insecurity, and climate vulnerability. In Cap-Haitien where SOIL operates, only 1% of the population has access to a safely managed sanitation system. Recent research showed that human feces produced in Haiti can meet up to 13, 22, and 11% of major crop needs of nitrogen, phosphorus, and potassium, respectively, as well as provide a source of organic matter. In addition to circular nutrient management, improved food security, and improved access to safely managed sanitation, EcoSan can support climate change solutions: mitigation of GHG emissions by converting from alternative waste management fates; avoidance of GHG emissions from the displacement of mineral fertilizers by compost; promotion of soil carbon sequestration; and increased adaptability of agroecosystems.

Planners and engineers must consider how systems can be designed to assure access to basic services like access to water and safely-managed sanitation while stewarding planetary health. This is a strategic concern applicable not only to those contexts where safely-managed sanitation services have not yet been established but to all contexts. Ecological sanitation is an approach to sanitation that manages the flow of freshwater and nutrients based on sustainable biogeochemical cycles, supports agricultural productivity, mitigates negative environmental impacts, and provides a foundation for global socioeconomic equity.


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Generating better understanding of the links between accelerating global environmental change and human health to support policy making and public education