Making pathogen hazards visible: a new heuristic to improve sanitation investment efficacy
The public health objective of sanitation is to reduce the risk of negative health outcomes from faecal contamination. For water-based sanitation systems at the household and community scale as practised in Indonesia and perhaps elsewhere, the liquid component of the effluent comprises a significant pathogen hazard. While increasing attention is paid to managing the solid fraction, the hazard in the liquid fraction goes largely unnoticed and unmanaged. This paper proposes the means for a conceptual shift to a focus on the pathogen hazards that matter post-treatment, and where those hazards enter the environment, enabling improved local risk management. Firstly, the paper proposes exponential, rather than arithmetic, representations of pathogen number or concentration, because arithmetic representations of treatment efficacy wrongly suggest low cause for concern. Secondly, the paper introduces and applies the Pathogen Hazard Diagram, a new heuristic applicable at both the local and national scale, that requires only local knowledge and general sanitation reference knowledge to construct, but which can guide policy and action, direct monitoring, and improve the efficacy of sanitation investments.Bill & Melinda Gates Foundation (2010) Water, Sanitation & Hygiene Fact Sheet [pdf] <https://docs.gatesfoundation.org/documents/water-sanitation-hygiene-fact-sheet-2010.pdf> [accessed 3 March 2016].
Blackett, I., Hawkins, P. and Heymans, C. (2014) The Missing Link in Sanitation Service Delivery: A Review of Fecal Sludge Management in 12 Cities, pp. 1–8, Targeting the Urban Poor and Improving Services in Small Towns, Water and Sanitation Program Research Brief, Washington, DC: WSP.
Environmental Technology Initiative (ETI) (1998) Mound Systems: Fact Sheet [pdf], Morgantown, WV: National Small Flows Clearinghouse <www.nesc.wvu.edu/pdf/WW/publications/eti/mounds_tech.pdf> [accessed 29 February 2016].
Feachem, R.G., Bradley, D.J., Garelick, H. and Mara, D.D. (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, New York: John Wiley & Sons <http://go.worldbank.org/ZS7F3M9XG1> [accessed 29 February 2016].
Foxon, K.M. (2009) Analysis of a Pilot Scale Anaerobic Baffled Reactor Treating Domestic Wastewater, PhD thesis, Durban, South Africa: University of KwaZulu-Natal.
Hutton, G. (2013) ‘Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage’, Journal of Water and Health 11(1): 1–12 <http://dx.doi.org/10.2166/wh.2012.105>.
Indonesian Ministry of Public Works (2013) Petunjuk Pelaksanaan Dala Alokasi Khusus Sanitasi Lingkungan Berbasis Masyarakat (Implementation Guidelines for community based sanitation funded by special allocation grant DAK SLBM), Jakarta: Indonesian Ministry of Public Works.
Jimenez-Cisneros, B.E. and Maya-Rendon, C. (2007) ‘Helminths and sanitation’, in A. Méndez-Vilas (ed.), Communicating Current Research and Educational Topics and Trends in Applied Microbiology, 1, pp. 60–71, Extremadura: Formatex <http://www.formatex.org/microbio/> [accessed 3 March 2016].
Kolsky, P. (2015) ‘Can we estimate what happens after the toilet, and is it worth trying?’ presentation at the Water and Health Conference 2015, The Water Institute at University of North Carolina, Chapel Hill.
Leclerc, H., Schwartsbrod, L. and Dei-Cas, E. (2004) ‘Microbial agents associated with waterborne diseases’, in T.E. Cloete, J. Rose, L.H. Nel and T. Ford (eds.), Microbial Waterborne Pathogens, pp. 1–54, London: IWA Publishing.
Lowe, K.S., Rothe, N.K., Tomaras, J.M.B., DeJong, K., Tucholke, M.B., Drewes, J., McCray, J.E. and Munakata-Marr, J. (2007) Influent Constituent Characteristics of the Modern Waste Stream from Single Sources: Literature Review, WERF project 04-DEC-1, Alexandria, VA: Water Environment Research Foundation.
Mawdsley, J.L., Brooks, A.E. and Merry, R.J. (1996) ‘Movement of the protozoan pathogen Cryptosporidium parvum through Three Contrasting Soil Types’, Biology and Fertility of Soils 21: 30–6.
McCray, J., Lowe, K., Geza, M., Drewes, J., Roberts, S., Wunsch, A., Radcliffe, D., Amador, J., Atoyan, J., Boving, T., Kalen, D. and Loomis, G. (2009) State of the Science: Review of Quantitative Tools to Determine Wastewater Soil Treatment Unit Performance, Alexandria, VA: Water Environment Research Foundation (WERF).
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Mills, F. (2013) Assessment of Sludge Accumulation and Pit Filling Rates in Indonesia, Washington, DC: World Bank Water and Sanitation Program.
Mitchell, C., Ross, K., Abeysuriya, K., Puspowardoyo, P. and Wedahuditama, F. (2015) Effective Governance for the Successful Long-term Operation of Community Scale Air Limbah Systems: Mid-term Observations Report, Sydney: Institute for Sustainable Futures, University of Technology Sydney.
Napitupulu, L. and Hutton, G. (2008) Economic Impacts of Sanitation in Indonesia [pdf], Jakarta: World Bank, Water and Sanitation Program <https://www.wsp.org/sites/wsp.org/files/publications/esi_indonesia.pdf> [accessed 1 March 2016].
Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.
Ogden, S., Gallo, K., Davis, S., McGuire, C., Meyer, E., Addiss, D. and Haddad, D. (2013) WASH and the Neglected Tropical Diseases: A Manual for WASH Implementers – Indonesia, Sightsavers, DFID, International Trachoma Initiative, Children Without Worms, WaterAid, Wash Advocates, Emory University Center for Global Safe Water, and Care USA.
Robbins, D., Carriero, M. and Suartana, N. (2015) ‘Utilising rapid technical assessments to develop a city-wide desludging programme’, Water 21, June 2015.
Ropeik, D. and Gray, G. (2002) Risk: A Practical Guide for Deciding What’s Really Safe and What’s Really Dangerous in the World Around You, New York: Houghton Mifflin Harcourt.
Ross, K., Abeysuriya, K. and Mitchell, C. (2015) ‘Developing principle-based targets and indicators for the SDGs’, in 2015 International Conference on Sustainable Development, 23–24 September 2015, New York.
SaniPath (2015) ‘SaniPath Rapid Assessment Tool’ [online], Bill & Melinda Gates Foundation, Emory Rollins School of Public Health and Center for Global Safe WASH <sanipath.org> [accessed 1 March 2016].
Schmidt, C.W. (2014) ‘Beyond malnutrition: the role of sanitation in stunted growth’, Environmental Health Perspectives 122(11): 298–303 <http://dx.doi.org/10.1289/ehp.122-A298>.
SFD Promotion Initiative (2015) Manual for SFD Production Draft Version 1.0 [online], Sustainable Sanitation Alliance <www.susana.org/en/resources/library/details/2357> [accessed 1 March 2016].
Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 1 March 2016].
Stevik, T.K., Aa, K., Ausland, G. and Hanssen, J.F. (2004) ‘Retention and removal of pathogenic bacteria in wastewater percolating through porous media: a review’, Water Research 38(6): 1355–67 <http://dx.doi.org/10.1016/j.watres.2003.12.024>.
Strande, L., Ronteltap, M. and Brdjanovic, D. (eds) (2014) Faecal Sludge Management: Systems Approach for Implementation and Operation, London: IWA Publishing.
Tayler, K., Siregar, R., Darmawan, B., Blackett, I. & Giltner, S. (2013) ‘Development of urban septage management models in Indonesia’, Waterlines 32(3): 221–36 <http://dx.doi.org/10.3362/1756-3488.2013.023>.
Tejalaksana, A. (2010) ‘Urbanization and water quality control for the source of water in Jakarta’, in Water Environment Partnership in Asia (WEPA): The First International Workshop. Coping Strategies for Water Environmental Challenges in Asia, Hanoi, Viet Nam: Section of Clearinghouse, State Ministry of Environment, Indonesia.
Toze, S. (1997) Microbial Pathogens in Wastewater: Literature Review for Urban Water Systems Multi-divisional Research Program, Technical Report No 1/97, June 1997, Dickson, ACT: CSIRO Land and Water, Australia.
Ulrich, A., Reuter, S. and Gutterer, B. (eds.) (2009) Decentralised Wastewater Treatment Systems (DEWATS) and Sanitation in Developing Countries: A Practical Guide, Bremen, Germany: BORDA and Loughborough, UK: Water, Engineering and Development Centre (WEDC).
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United Nations Statistics Division (UNSD) (2015) ‘Millennium Development Goals Indicators: Goal 7 Ensure environmental sustainability’ [online] <http://mdgs.un.org/unsd/mdg/Metadata.aspx?IndicatorId=31> [accessed 29 August 2015].
US EPA (2002) Onsite Wastewater Treatment System Manual [pdf], Washington, DC: Office of Water, US Environmental Protection Agency <https://www.norweco.com/pdf/EPA/625R00008.pdf> [accessed 8 March 2016].
Vinnerås, B., Hedenkvist, M., Nordin, A. and Wilhelmson, A. (2009) ‘Peepoo bag: self-sanitising single use biodegradable toilet’, Water Science and Technology 59(9): 1743–9 <http://dx.doi.org/10.2166/wst.2009.184>.
Water and Sanitation Program (WSP) (2011) Economic Assessment of Sanitation Interventions in Indonesia: A Six-country Study Conducted in Lao PDR, the Philippines and Vietnam under the Economics of Sanitation Initiative (ESI), Technical Paper, Jakarta: Water and Sanitation Program.
Williams, A.R. and Overbo, A. (2015) Unsafe Return of Human Excreta to the Environment: A Literature Review [pdf], Chapel Hill, NC: The Water Institute at UNC <https://waterinstitute.unc.edu/files/2015/07/BMGF_UnsafeReturn_LitReview_UNC_16June15.pdf> [accessed 3 March 2016].
World Bank (2012) Indonesia Water Investment Roadmap 2011–2014 [pdf], Washington, DC: World Bank <http://water.worldbank.org/sites/water.worldbank.org/files/publication/WATER-Indonesia-Water-Investment-Roadmap-2011-2014.pdf> [accessed 3 March 2016].
World Health Organisation (WHO) (2006) Guidelines for the Safe Use of Wastewater, Excreta and Greywater, Geneva: WHO.
WHO (2015) Sanitation Safety Planning: Manual for Safe Use and Disposal of Wastewater, Greywater and Excreta, Geneva: WHO.
Bill & Melinda Gates Foundation (2010) Water, Sanitation & Hygiene Fact Sheet [pdf] <https://docs.gatesfoundation.org/documents/water-sanitation-hygiene-fact-sheet-2010.pdf> [accessed 3 March 2016].
Blackett, I., Hawkins, P. and Heymans, C. (2014) The Missing Link in Sanitation Service Delivery: A Review of Fecal Sludge Management in 12 Cities, pp. 1–8, Targeting the Urban Poor and Improving Services in Small Towns, Water and Sanitation Program Research Brief, Washington, DC: WSP.
Environmental Technology Initiative (ETI) (1998) Mound Systems: Fact Sheet [pdf], Morgantown, WV: National Small Flows Clearinghouse <www.nesc.wvu.edu/pdf/WW/publications/eti/mounds_tech.pdf> [accessed 29 February 2016].
Feachem, R.G., Bradley, D.J., Garelick, H. and Mara, D.D. (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, New York: John Wiley & Sons <http://go.worldbank.org/ZS7F3M9XG1> [accessed 29 February 2016].
Foxon, K.M. (2009) Analysis of a Pilot Scale Anaerobic Baffled Reactor Treating Domestic Wastewater, PhD thesis, Durban, South Africa: University of KwaZulu-Natal.
Hutton, G. (2013) ‘Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage’, Journal of Water and Health 11(1): 1–12 <http://dx.doi.org/10.2166/wh.2012.105>.
Indonesian Ministry of Public Works (2013) Petunjuk Pelaksanaan Dala Alokasi Khusus Sanitasi Lingkungan Berbasis Masyarakat (Implementation Guidelines for community based sanitation funded by special allocation grant DAK SLBM), Jakarta: Indonesian Ministry of Public Works.
Jimenez-Cisneros, B.E. and Maya-Rendon, C. (2007) ‘Helminths and sanitation’, in A. Méndez-Vilas (ed.), Communicating Current Research and Educational Topics and Trends in Applied Microbiology, 1, pp. 60–71, Extremadura: Formatex <http://www.formatex.org/microbio/> [accessed 3 March 2016].
Kolsky, P. (2015) ‘Can we estimate what happens after the toilet, and is it worth trying?’ presentation at the Water and Health Conference 2015, The Water Institute at University of North Carolina, Chapel Hill.
Leclerc, H., Schwartsbrod, L. and Dei-Cas, E. (2004) ‘Microbial agents associated with waterborne diseases’, in T.E. Cloete, J. Rose, L.H. Nel and T. Ford (eds.), Microbial Waterborne Pathogens, pp. 1–54, London: IWA Publishing.
Lowe, K.S., Rothe, N.K., Tomaras, J.M.B., DeJong, K., Tucholke, M.B., Drewes, J., McCray, J.E. and Munakata-Marr, J. (2007) Influent Constituent Characteristics of the Modern Waste Stream from Single Sources: Literature Review, WERF project 04-DEC-1, Alexandria, VA: Water Environment Research Foundation.
Mawdsley, J.L., Brooks, A.E. and Merry, R.J. (1996) ‘Movement of the protozoan pathogen Cryptosporidium parvum through Three Contrasting Soil Types’, Biology and Fertility of Soils 21: 30–6.
McCray, J., Lowe, K., Geza, M., Drewes, J., Roberts, S., Wunsch, A., Radcliffe, D., Amador, J., Atoyan, J., Boving, T., Kalen, D. and Loomis, G. (2009) State of the Science: Review of Quantitative Tools to Determine Wastewater Soil Treatment Unit Performance, Alexandria, VA: Water Environment Research Foundation (WERF).
MCA – Indonesia (2013) Stunting and the Future of Indonesia [pdf], <http://mca-indonesia.go.id/wp-content/uploads/2015/01/Backgrounder-Stunting-EN.pdf> Jakarta: MCA – Indonesia [accessed 29 February 2016].
Mills, F. (2013) Assessment of Sludge Accumulation and Pit Filling Rates in Indonesia, Washington, DC: World Bank Water and Sanitation Program.
Mitchell, C., Ross, K., Abeysuriya, K., Puspowardoyo, P. and Wedahuditama, F. (2015) Effective Governance for the Successful Long-term Operation of Community Scale Air Limbah Systems: Mid-term Observations Report, Sydney: Institute for Sustainable Futures, University of Technology Sydney.
Napitupulu, L. and Hutton, G. (2008) Economic Impacts of Sanitation in Indonesia [pdf], Jakarta: World Bank, Water and Sanitation Program <https://www.wsp.org/sites/wsp.org/files/publications/esi_indonesia.pdf> [accessed 1 March 2016].
Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.
Ogden, S., Gallo, K., Davis, S., McGuire, C., Meyer, E., Addiss, D. and Haddad, D. (2013) WASH and the Neglected Tropical Diseases: A Manual for WASH Implementers – Indonesia, Sightsavers, DFID, International Trachoma Initiative, Children Without Worms, WaterAid, Wash Advocates, Emory University Center for Global Safe Water, and Care USA.
Robbins, D., Carriero, M. and Suartana, N. (2015) ‘Utilising rapid technical assessments to develop a city-wide desludging programme’, Water 21, June 2015.
Ropeik, D. and Gray, G. (2002) Risk: A Practical Guide for Deciding What’s Really Safe and What’s Really Dangerous in the World Around You, New York: Houghton Mifflin Harcourt.
Ross, K., Abeysuriya, K. and Mitchell, C. (2015) ‘Developing principle-based targets and indicators for the SDGs’, in 2015 International Conference on Sustainable Development, 23–24 September 2015, New York.
SaniPath (2015) ‘SaniPath Rapid Assessment Tool’ [online], Bill & Melinda Gates Foundation, Emory Rollins School of Public Health and Center for Global Safe WASH <sanipath.org> [accessed 1 March 2016].
Schmidt, C.W. (2014) ‘Beyond malnutrition: the role of sanitation in stunted growth’, Environmental Health Perspectives 122(11): 298–303 <http://dx.doi.org/10.1289/ehp.122-A298>.
SFD Promotion Initiative (2015) Manual for SFD Production Draft Version 1.0 [online], Sustainable Sanitation Alliance <www.susana.org/en/resources/library/details/2357> [accessed 1 March 2016].
Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 1 March 2016].
Stevik, T.K., Aa, K., Ausland, G. and Hanssen, J.F. (2004) ‘Retention and removal of pathogenic bacteria in wastewater percolating through porous media: a review’, Water Research 38(6): 1355–67 <http://dx.doi.org/10.1016/j.watres.2003.12.024>.
Strande, L., Ronteltap, M. and Brdjanovic, D. (eds) (2014) Faecal Sludge Management: Systems Approach for Implementation and Operation, London: IWA Publishing.
Tayler, K., Siregar, R., Darmawan, B., Blackett, I. & Giltner, S. (2013) ‘Development of urban septage management models in Indonesia’, Waterlines 32(3): 221–36 <http://dx.doi.org/10.3362/1756-3488.2013.023>.
Tejalaksana, A. (2010) ‘Urbanization and water quality control for the source of water in Jakarta’, in Water Environment Partnership in Asia (WEPA): The First International Workshop. Coping Strategies for Water Environmental Challenges in Asia, Hanoi, Viet Nam: Section of Clearinghouse, State Ministry of Environment, Indonesia.
Toze, S. (1997) Microbial Pathogens in Wastewater: Literature Review for Urban Water Systems Multi-divisional Research Program, Technical Report No 1/97, June 1997, Dickson, ACT: CSIRO Land and Water, Australia.
Ulrich, A., Reuter, S. and Gutterer, B. (eds.) (2009) Decentralised Wastewater Treatment Systems (DEWATS) and Sanitation in Developing Countries: A Practical Guide, Bremen, Germany: BORDA and Loughborough, UK: Water, Engineering and Development Centre (WEDC).
UN (2015) ‘Sustainable Development Goals’ [online], Sustainable Development Knowledge Platform <https://sustainabledevelopment.un.org/?menu=1300> [accessed 28 October 2015].
United Nations Development Programme (UNDP) (2006) Human Development Report 2006, Beyond Scarcity: Power, Poverty and the Global Water Crisis [online], New York: UNDP <http://hdr.undp.org/en/content/human-development-report-2006> [accessed 1 March 2016].
United Nations Statistics Division (UNSD) (2015) ‘Millennium Development Goals Indicators: Goal 7 Ensure environmental sustainability’ [online] <http://mdgs.un.org/unsd/mdg/Metadata.aspx?IndicatorId=31> [accessed 29 August 2015].
US EPA (2002) Onsite Wastewater Treatment System Manual [pdf], Washington, DC: Office of Water, US Environmental Protection Agency <https://www.norweco.com/pdf/EPA/625R00008.pdf> [accessed 8 March 2016].
Vinnerås, B., Hedenkvist, M., Nordin, A. and Wilhelmson, A. (2009) ‘Peepoo bag: self-sanitising single use biodegradable toilet’, Water Science and Technology 59(9): 1743–9 <http://dx.doi.org/10.2166/wst.2009.184>.
Water and Sanitation Program (WSP) (2011) Economic Assessment of Sanitation Interventions in Indonesia: A Six-country Study Conducted in Lao PDR, the Philippines and Vietnam under the Economics of Sanitation Initiative (ESI), Technical Paper, Jakarta: Water and Sanitation Program.
Williams, A.R. and Overbo, A. (2015) Unsafe Return of Human Excreta to the Environment: A Literature Review [pdf], Chapel Hill, NC: The Water Institute at UNC <https://waterinstitute.unc.edu/files/2015/07/BMGF_UnsafeReturn_LitReview_UNC_16June15.pdf> [accessed 3 March 2016].
World Bank (2012) Indonesia Water Investment Roadmap 2011–2014 [pdf], Washington, DC: World Bank <http://water.worldbank.org/sites/water.worldbank.org/files/publication/WATER-Indonesia-Water-Investment-Roadmap-2011-2014.pdf> [accessed 3 March 2016].
World Health Organisation (WHO) (2006) Guidelines for the Safe Use of Wastewater, Excreta and Greywater, Geneva: WHO.
WHO (2015) Sanitation Safety Planning: Manual for Safe Use and Disposal of Wastewater, Greywater and Excreta, Geneva: WHO.
Bill & Melinda Gates Foundation (2010) Water, Sanitation & Hygiene Fact Sheet [pdf] <https://docs.gatesfoundation.org/documents/water-sanitation-hygiene-fact-sheet-2010.pdf> [accessed 3 March 2016].
Blackett, I., Hawkins, P. and Heymans, C. (2014) The Missing Link in Sanitation Service Delivery: A Review of Fecal Sludge Management in 12 Cities, pp. 1–8, Targeting the Urban Poor and Improving Services in Small Towns, Water and Sanitation Program Research Brief, Washington, DC: WSP.
Environmental Technology Initiative (ETI) (1998) Mound Systems: Fact Sheet [pdf], Morgantown, WV: National Small Flows Clearinghouse <www.nesc.wvu.edu/pdf/WW/publications/eti/mounds_tech.pdf> [accessed 29 February 2016].
Feachem, R.G., Bradley, D.J., Garelick, H. and Mara, D.D. (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, New York: John Wiley & Sons <http://go.worldbank.org/ZS7F3M9XG1> [accessed 29 February 2016].
Foxon, K.M. (2009) Analysis of a Pilot Scale Anaerobic Baffled Reactor Treating Domestic Wastewater, PhD thesis, Durban, South Africa: University of KwaZulu-Natal.
Hutton, G. (2013) ‘Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage’, Journal of Water and Health 11(1): 1–12 <http://dx.doi.org/10.2166/wh.2012.105>.
Indonesian Ministry of Public Works (2013) Petunjuk Pelaksanaan Dala Alokasi Khusus Sanitasi Lingkungan Berbasis Masyarakat (Implementation Guidelines for community based sanitation funded by special allocation grant DAK SLBM), Jakarta: Indonesian Ministry of Public Works.
Jimenez-Cisneros, B.E. and Maya-Rendon, C. (2007) ‘Helminths and sanitation’, in A. Méndez-Vilas (ed.), Communicating Current Research and Educational Topics and Trends in Applied Microbiology, 1, pp. 60–71, Extremadura: Formatex <http://www.formatex.org/microbio/> [accessed 3 March 2016].
Kolsky, P. (2015) ‘Can we estimate what happens after the toilet, and is it worth trying?’ presentation at the Water and Health Conference 2015, The Water Institute at University of North Carolina, Chapel Hill.
Leclerc, H., Schwartsbrod, L. and Dei-Cas, E. (2004) ‘Microbial agents associated with waterborne diseases’, in T.E. Cloete, J. Rose, L.H. Nel and T. Ford (eds.), Microbial Waterborne Pathogens, pp. 1–54, London: IWA Publishing.
Lowe, K.S., Rothe, N.K., Tomaras, J.M.B., DeJong, K., Tucholke, M.B., Drewes, J., McCray, J.E. and Munakata-Marr, J. (2007) Influent Constituent Characteristics of the Modern Waste Stream from Single Sources: Literature Review, WERF project 04-DEC-1, Alexandria, VA: Water Environment Research Foundation.
Mawdsley, J.L., Brooks, A.E. and Merry, R.J. (1996) ‘Movement of the protozoan pathogen Cryptosporidium parvum through Three Contrasting Soil Types’, Biology and Fertility of Soils 21: 30–6.
McCray, J., Lowe, K., Geza, M., Drewes, J., Roberts, S., Wunsch, A., Radcliffe, D., Amador, J., Atoyan, J., Boving, T., Kalen, D. and Loomis, G. (2009) State of the Science: Review of Quantitative Tools to Determine Wastewater Soil Treatment Unit Performance, Alexandria, VA: Water Environment Research Foundation (WERF).
MCA – Indonesia (2013) Stunting and the Future of Indonesia [pdf], <http://mca-indonesia.go.id/wp-content/uploads/2015/01/Backgrounder-Stunting-EN.pdf> Jakarta: MCA – Indonesia [accessed 29 February 2016].
Mills, F. (2013) Assessment of Sludge Accumulation and Pit Filling Rates in Indonesia, Washington, DC: World Bank Water and Sanitation Program.
Mitchell, C., Ross, K., Abeysuriya, K., Puspowardoyo, P. and Wedahuditama, F. (2015) Effective Governance for the Successful Long-term Operation of Community Scale Air Limbah Systems: Mid-term Observations Report, Sydney: Institute for Sustainable Futures, University of Technology Sydney.
Napitupulu, L. and Hutton, G. (2008) Economic Impacts of Sanitation in Indonesia [pdf], Jakarta: World Bank, Water and Sanitation Program <https://www.wsp.org/sites/wsp.org/files/publications/esi_indonesia.pdf> [accessed 1 March 2016].
Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.
Ogden, S., Gallo, K., Davis, S., McGuire, C., Meyer, E., Addiss, D. and Haddad, D. (2013) WASH and the Neglected Tropical Diseases: A Manual for WASH Implementers – Indonesia, Sightsavers, DFID, International Trachoma Initiative, Children Without Worms, WaterAid, Wash Advocates, Emory University Center for Global Safe Water, and Care USA.
Robbins, D., Carriero, M. and Suartana, N. (2015) ‘Utilising rapid technical assessments to develop a city-wide desludging programme’, Water 21, June 2015.
Ropeik, D. and Gray, G. (2002) Risk: A Practical Guide for Deciding What’s Really Safe and What’s Really Dangerous in the World Around You, New York: Houghton Mifflin Harcourt.
Ross, K., Abeysuriya, K. and Mitchell, C. (2015) ‘Developing principle-based targets and indicators for the SDGs’, in 2015 International Conference on Sustainable Development, 23–24 September 2015, New York.
SaniPath (2015) ‘SaniPath Rapid Assessment Tool’ [online], Bill & Melinda Gates Foundation, Emory Rollins School of Public Health and Center for Global Safe WASH <sanipath.org> [accessed 1 March 2016].
Schmidt, C.W. (2014) ‘Beyond malnutrition: the role of sanitation in stunted growth’, Environmental Health Perspectives 122(11): 298–303 <http://dx.doi.org/10.1289/ehp.122-A298>.
SFD Promotion Initiative (2015) Manual for SFD Production Draft Version 1.0 [online], Sustainable Sanitation Alliance <www.susana.org/en/resources/library/details/2357> [accessed 1 March 2016].
Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 1 March 2016].
Stevik, T.K., Aa, K., Ausland, G. and Hanssen, J.F. (2004) ‘Retention and removal of pathogenic bacteria in wastewater percolating through porous media: a review’, Water Research 38(6): 1355–67 <http://dx.doi.org/10.1016/j.watres.2003.12.024>.
Strande, L., Ronteltap, M. and Brdjanovic, D. (eds) (2014) Faecal Sludge Management: Systems Approach for Implementation and Operation, London: IWA Publishing.
Tayler, K., Siregar, R., Darmawan, B., Blackett, I. & Giltner, S. (2013) ‘Development of urban septage management models in Indonesia’, Waterlines 32(3): 221–36 <http://dx.doi.org/10.3362/1756-3488.2013.023>.
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