Monday, December 21, 2015

New articles from the SHINE trial in Zimbabwe

Just out-- a special supplement in the Dec issue of Clinical Infectious Diseases with 9 open-source articles from the Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) Trial Team in Zimbabwe.

A few highlights...

1. An innovative behavior change communication campaign to promote safe child stool disposal, handwashing with soap, water treatment, protected exploratory play, and hygienic infant feeding:

2. Using open source software and village health worker networks to map baseline access to water and sanitation to inform randomization of household clusters within the SHINE trial:

3. Current concepts of environmental enteric dysfunction (EED), challenges in defining the condition, and how SHINE is evaluating EED using a panel of biomarkers:

New postdoc positions at Duke and Johns Hopkins

Several interesting postdoctoral positions available for 2016 (contact labs directly for more information):

1. Advanced proof of concept of a household sanitation system using anaerobic digestion and heat pasteurization for use in less-developed countries

Department of Civil and Environmental Engineering, Duke University, Durham, NC

Start date: Jan. 1 - Feb. 29, 2016

We are seeking a Postdoctoral Researcher to join a small, focused team evaluating and evolving the ADPL design and implementation in Kenya, India and the Philippines. Over the next 15 months, the scope and quality of monitoring of the existing field units will be expanded. The heat pasteurization system will undergo design changes for improved efficiency, and the digester will be redesigned for increased biogas production. Additional efforts will be taken to improve the commercial value and market readiness.

Interested and qualified candidates please send a CV and a brief statement of interest to: Kathy Jooss - Project Manager, Pratt School of Engineering, Duke University,

2. Performance Monitoring Accountability 2020 Schistosomiasis Postdoctoral Fellowship

Johns Hopkins University Bloomberg School of Public Health seeks a postdoctoral fellow with a background in Water, Sanitation, and Hygiene (WASH), and environmental microbiology or molecular techniques as part of Performance Monitoring Accountability 2020 ( PMA 2020 is a high impact, high profile public health study that is designed to drive global policy at the nexus of family planning, women’s empowerment, water, sanitation, and hygiene. 

PMA 2020 will launch a new study in Uganda to obtain national assessment of the impact of ongoing Schistosomiasis control programs. The postdoc will oversee PMA2020’s objectives in data collection, in-country training, and data analysis.

More information here:

3. Performance Monitoring Accountability 2020 Geospatial Postdoctoral Fellowship

The Johns Hopkins Bloomberg School of Public Health seeks a postdoctoral fellow with a background in spatial statistics and GIS as part of Performance Monitoring Accountability 2020 ( PMA2020 is a high impact, high profile public health study that is designed to drive global policy at the nexus of family planning, women’s empowerment, water, sanitation, and hygiene. 

The postdoctoral fellow will work and be primarily located at JHSPH to work with the two faculty mentors on an as-needed basis; together the postdoc and mentors form the “geospatial team.” The postdoc will facilitate PMA2020’s objectives in data collection, data visualization, in-country training, and data analysis as follows.

More Information here:


Friday, November 20, 2015

World Toilet (Yester)Day: Not All Can Flush and Forget

See fully formatted blog post on medium here:

Chances are most people in the developed world can easily access a safe, convenient toilet. Globally, however, more than one in four people live in a world without access to a decent sanitation facility.
On World Toilet Day, the global health community is focusing on the needs of more than 1 billion people who defecate in the open. Poor sanitation contributes to thousands of deaths from diarrheal diseases every year. A lack of secure and private restrooms for women and girls also increases the risk of rape and abuse, and causes many girls to stop attending school. Equitable sanitation access can no longer afford to be a neglected global issue. Gains in sanitation coverage in sub-Saharan Africa and South Asia have not even been able to keep pace with population growth, particularly in urban areas.

What kind of toilets are people using around the world, and are they safe? Five examples below show models used around the world.

1. Flying Toilets (far from ideal)

Roughly one in seven people worldwide defecate in the open or use plastic bags — termed “flying toilets” — that they throw as far as possible when they’re done. Flying toilets are commonly used everywhere from Haiti to Kiberia, Africa’s largest urban slum. These practices directly expose children and adults to harmful bacteria, and can contaminate drinking water, especially during floods. Additionally, flies can easily access feces and spread germs to food sources. Open defecation is the least safe waste disposal option.

2. Bag and Bury It (good for emergencies)

A U.N. study indicated that worldwide, almost one third of refugee camps do not have adequate latrines or waste disposal services. For example, in early November, several NGOs denounced “serious human rights violations” due to lack of sanitation services at a migrant camp in Calais, France that held thousands of refugees. This prompted a court in to order the town to install 50 latrines to improve sanitation, according to The Guardian. Another sanitation option is a single-use biodegradable toilet, which can serve as a transition solution for such emergency situations. Not only does the biodegradable bag prevent contamination — if processed properly, it can later be converted to compost.

3. Covered Latrines (community buy-in makes the difference)

Covered latrines — pits that store fecal matter and are sealed when full — are one low-tech solution to open defecation. A program underway in over 50 countries, “community-led total sanitation” uses behavior change techniques to motivate communities to stop open defecation by building — and using — pit latrines. Among the promising results of the effort, increased latrine use has reduced stunting among young children in the communities, according to a study co-authored by a Stanford researcher.

4. Container-Based With Subscription Waste-Removal (no plumbing required)

A waterless toilet and waste collection service being piloted in Haiti and other countries may provide a significant health benefit in dense urban settings. A key feature of the waterless toilet — built to resemble a modern flush toilet — is that it separates solid and liquid waste into sealable containers. The liquid can be disposed of in the natural environment, while solids are mixed with a cover material made of natural material such as crushed peanut shells and sugarcane fibers, which absorb odors and reduce insect infestations. The solid waste is regularly removed and taken to a disposal or processing site where it can be converted to compost.
Uptake of this new technology requires behavior change and a willingness to pay for the service. Both requirements were largely met in a study led by researchers with the Stanford Woods Institute’s Water, Health & Development program.

5. Full-Featured Flush (taps water and energy)

When most residents of the developed world think of a toilet, they imagine a ceramic bowl plumbed to a water source. This system, while convenient and sanitary, allows people to “flush and forget” — once they flush the toilet, they don’t need to think twice about the complex process that ensues, using large quantities of water to send waste to a community sewage plant where solids and liquids are treated to safety standards and released to surface waters.
While obtaining potable water is a major challenge for people in developing countries, many wealthy countries are going through great efforts to treat water to drinking standards — and then using it for their toilets. But some cities are leading the way. For example, Hong Kong has a long history of dual systems in which potable water is used for sinks and showers, and non-potable water is used for flushing toilets. San Francisco is working to make it easier for residents to install systems that use “grey-water” from sinks and showers to flush toilets or water gardens.

If you are lucky enough to have a flush toilet, rather than “flush and forget”, consider investigating where your water comes from and where your sewage ends up. This may make you “flush and feel thankful” that your sewage isn’t contaminating your local drinking water and surrounding environment.