Adequate access to sanitation and safe water is a main challenge to improve urban health in low-income countries. Diseases derived of precarious hygiene conditions are a major burden in African rapidly growing urban areas. These challenges are embedded in complex stakeholder networks and need to be addressed through a holistic approach. It is argued that schools are a key objective for sanitation, water, and hygiene actions in the city. Concerns for improvement of hygiene conditions among school children have risen in the context of contemporary sanitary crisis. Furthermore, schools play a pivotal role between the public and the private realms and a potential to foster change. The study focuses on WASH actions implemented in schools of the city of Makeni, Sierra Leone. It seeks to define a set of context specific recommendations to improve the health-related conditions in the school environment.
TopIntroduction
Eleventh Sustainable Development Goal (SDG11) of the UN 2030 Agenda calls for “inclusive, safe, resilient and sustainable” cities, but the very notion of sustainable cities is, as we know, problematic. And this is specially so in vulnerable urban environments. When confronted with the rapid and chaotic growth of some African cities, these concepts take a very different meaning than that we may find in first world contexts. In Herbert Girardet´s seminal definition, the sustainable city is “organised so as to enable all of its citizens to meet their own needs” in a sustainable way (Girardet, 1999).
Sustainable environments in this sense, necessarily address necessities and equity among all citizens. In urban contexts where there is a demand of basic services such as water or sanitation, the lack of access to these infrastructures is cause to inequity and vulnerability. This takes us to World Health Organization (WHO) definition of healthy cities, that points out how the Healthy City tackles the needs of its inhabitants by enhancing community capacities:
A Healthy City is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. (Goldstein & Kickbusch, 1996)
It is therefore at the community scale where the response to necessities is organised through enabling environments that foster mutual support. Improvement of common resources in the neighbourhood environment is, thus, a key aspect to generate healthier and more sustainable cities.
The 2030 Agenda´s SDG6, on the other hand, emphasizes the need of clean water and sanitation to “ensure availability and sustainable management of water and sanitation for all”. Access to adequate sanitation is a main challenge to improve urban health worldwide, significantly so in developing countries. According to the U.N., inadequate water, sanitation, and hygiene are related to large disease burdens concerning malnutrition, diarrhoea, or soil-transmitted parasites; deficits in this area led to 870,000 deaths worldwide in 2016 (United Nations, 2019). The U.N considers the efforts on this aspect must be doubled in order to achieve the 2030 Agenda´s goal of basic sanitation services for all. The space where these aspects meet is no other but the city´s public realm. It is in the public space, in the common resources and shared communal infrastructures, where the organization of the city as an enabling environment can be most directly addressed.
This is especially important in the informal urban contexts. Here, the public realm is more relevant than ever, setting the standards in terms of hygiene and sanitation. But also, because the urban infrastructure in informal contexts forms a significant part of the public space. Most of the access points to safe drinking water in places as Makeni, Sierra Leone, are public. These infrastructures generate gathering spaces around them that eventually become everyday landmarks in the urban fabric. In a landscape of limited formal resources, it is the infrastructure networks such as water, sewage, sanitation, public lighting, or green spaces, that project a greater visibility of the public realm by structuring everyday life and the urban landscape around them. It has been pointed out that place centred communities achieve greater relevance for those with reduced social mobility (Nash & Christie, 2003).