East Meets West (EMW) has been implementing its Clean Water Program (CWP) in the Central Region of Vietnam since 1996, providing piped and treated water to rural communes and hamlets. Over the last few months, To maximize community health impacts of improved RWSS facilities, it is recommended that the CWP support a community and school-based Information, Education and Communication (IEC) program to improve hygiene behavior and support for sanitation activities aimed at reducing water related diseases (e.g., diarrhea, skin diseases, worm diseases, etc.). The IEC will focus on improving hygiene practices such as hand washing with soap, community-level environmental sanitation, household level wastewater drainage (not sewerage) programs and community level solid waste management. Women, teachers, community leaders and local authorities and the poor will be encouraged to get involved in and benefit from IEC activities. The close working relationships already developed by EMW with local authorities in Quang Nam would help facilitate the implementation of such a program component.

The CWP has been expanded to include environmental sanitation (sanitary latrines and hygiene behavioral change promotion) for both the household and schools in communities served by EMW. While the environmental sanitation program is still in its nascent period, EMW plans to go back to all of its water system sites to provide sanitation infrastructure and hygiene behavioral change promotion. This program has just recently started.

1) In how many communities has EMW already developed sanitary latrines? So far, EMW support for sanitary latrine construction has been limited to 4 communes. About 200 (out of a total number of 500 households) family latrines have already been built in Tam Anh Nam commune, Nui Thanh district, Quang Nam province. The remaining 300 are still in progress.

3) How much do the improved latrines cost, and who pays? EMW agreed to partially subsidize 126 HH latrines (pour/flush latrines with septic tanks) in the first phase of this program. An additional 74 HH latrines will be completed in the second phase. The EMW subsidy is 25 USD out of the base cost of 125 USD for the standard HH latrine (these costs are slightly higher than the original proposed cost because of the steadily inflating cost of materials and skilled labor (see below). Given the significant unmet demand on the part of potential customers, EMW anticipates a substantial expansion of this program, as suitable funding sources are identified. Unmet demand for improved sanitation in Quang Nam (and some of the surrounding provinces) remains high, and EMW intends to help meet and further stimulate that demand.

4) What are the basic design features? The basic sanitary latrine is a one-hole, pour flush double vault (septic tank) latrine, with a shelter (typically brick ventilated walls, and a corrugated iron roof) for privacy. However, an increasing number of HHs prefer to upgrade their basic latrines to a bathroom that contains the latrine and bathing facilities, along with improved aesthetics (tiled walls are popular for those who can afford them). The EMW design is based on designs that were promoted by International Development Enterprises (IDE) during their recent multi-year market-based hygienic latrine promotion project in Quang Nam. EMW’s latrines have been constructed mainly in Quang Nam Province, which is also the main focus of the EMW Clean Water Program thus far. The EMW program takes advantage of the availability of trained latrine builders whom IDE had trained-up during their program, as well as IDE’s promotional and marketing activities that helped to identify and expand the market demand for hygienic latrines.

5) How about alternative latrine designs? – EMW also intends to initiate a pilot program for the promotion of Eco San latrines. Ecological sanitation (also called 'EcoSan') is structured on recycling principles that keep the eco-cycle in the sanitation process closed. This system uses human excreta as a resource: human waste is processed on site until they are free of pathogenic (disease-causing) organisms. After this process, the sanitized excreta can be used for agricultural purposes. EcoSan toilets have several advantages over standard pour-flush latrines, including an EcoSan toilet can solve problems like bad odors, flies and poor hygiene, and is a comfortable and safe alternative to pour flush latrines. However, as this is not a common design in Vietnam, EMW will promote the EcoSan toilet as a useful alternative to the standard pour-flush latrine. The extent to which they are financed under this project will depend upon the willing of families to adopt the new technology.

6) What is the typical cost of a HH latrine, and how does the co-financing arrangement work? The typical cost of a basic pour-flush latrine with a septic tank is about US$130 (about VND 2.1 million), reflecting the recent significant increase in the price of goods, materials and skilled labor in Vietnam, due at least in part to the booming local economy. EMW provides a subsidy of 20% of the cost of a basic pour/flush latrine as a financial stimulant to encourage families (especially low-income families) to build improved sanitary latrines. The EMW subsidy is 20% of the total cost, or about VND 420,000, or about $26/HH. Sometimes people choose to build upscale versions that cost up to $300-500 for a tiled bathroom, a pour-flush latrine(s) and a shower, financed by the users.

8) What are the future plans for expanding the Sanitary Latrine program? At this time, the overall EMW sanitary latrine program is still in its nascent stage. While in theory, EMW would prefer to promote and subsidize latrines for all families particip

7) What are the processes and institutional arrangements for program implementation? Although the sanitation program has been carried out somewhat informally thus far due to very limited funding, the basic EMW approach is to carry out a needs assessment in communities already supported by the EMW Clean Water Program, After the community is selected as project location, EMW then has official meetings with the CPC and interested community members to discuss various aspects of project implementation, including selection criteria, cost sharing, Plan of Action, implementation process, role and responsibilities of each of the parties, and the financial control system. The MOU between EMW and CPC is signed at this time confirming the agreed upon points. The Project Management Board is then established with the concurrence of Vice Chairman of Commune PC, the Head of Commune Health Station, Heads of project hamlets, and the Women’s Union. The CPC works with hamlet level officials and individual households to prepare the list of families potentially interested in building partially subsidized sanitary latrines. EMW water team staff then visit individual households to verify the interest of potential beneficiaries households. The subsequent meetings and technical training activities with selected beneficiaries is then conducted, including project orientation, fully informing potentially interested HHs of their roles and responsibilities, and discussing details of the implementation process. An Agreement / Registration letter between EMW and interested HHs is then signed officially The Project Management Board coordinates with EMW assigned staff who will guide and the implementation of follow up activities during project implementation. When the construction completed successfully and meets project quality control standards, the subsidy payment will be made directly to the HHs by EMW, witnessed by CPC and the PMB.

A Hygiene and Sanitation Education program will be carried out in coordination with the latrine construction program.

9) What level of funding is requested? EMW intends to co-finance the construction of improved sanitary latrines (both pour-flush septic latrines and EcoSan latrines) both at the $26 level. Depending upon their actual cost, the EcoSan latrine (which are likely to be less costly than the standard pour-flush latrine) subsidies will be less (but the same 25%). Interested beneficiaries will be given the informed choice of which latrine model they prefer. As the planned sanitary latrine program is intended to cover an initial 200 latrines, the total subsidy cost would be $5,000. This investment in improved environmental sanitation would build upon the existing EMW and community co-financed investment in the piped and treated rural water supply system, which these days, due to the steady inflation of the cost of goods, materials, and construction labor and management, runs about $40-$50,000, depending upon cost-related factors such as the:

• Number of house connections provided;
• Length of the transmission and distribution pipelines;
• Location, depth, production capacity, and quality of the raw water source (which in turn determines the complexity and consequent cost of the water treatment facilities), and
• Population density, which has a significant impact upon the cost of the water transmission and distribution pipelines. The cost of pipes is typically the single highest cost item in the typical water system construction budget.

Thus, this initial $5,000 research grant will support EMW’s efforts to expand and refine its pilot sanitary latrine program, and to assess beneficiary preference and subsequent interest in adopting the EcoSan latrine, once they understand the potential benefits of doing so. EMW representatives have already met with representatives of the Stockholm Institute to discuss their EcoSan program, and will discuss further details about customer preference, and relative costs. As such, this will serve as an informal initial pilot study about customer preference between the two types of latrines.

The proposed budget of $5,000 will cover the 25% subsidy cost of about 200 latrines, a mix of both EcoSan and standard pour-flush latrines with double vault septic tanks. Users will choose which model they prefer.

EMW, in the form of staff time for project development, community mobilization and liaison with local authorities, construction management and quality control. (25% of all materials and equipment cost).

Households that are willing to accept the 25% subsidy (about US $25) and pay the remaining 75% (about US$75. EcoSan latrines are likely to be somewhat less expensive than the standard latrine, which may may attract more people to select that choice..

Equivalent of US$ 5 for annual maintenance of latrines.