Inconvenient truth: unsafely managed fecal sludge after achieving MDG for decades in Thailand

Abstract

Abstract In most low- and middle-income countries, due to financial constraints and improper management practices, the expansion of conventional centralized systems to enhance wastewater management services is not practical. Despite the fact that the majority of the world population has met the Millennium Development Goals 7c (MDG7c) targets, more than 2.5 billion are still using unimproved sanitation facilities and affecting the safety of drinking water and public health. Because of this problem, a novel approach on ‘Non-Sewered Sanitation’ with decentralized treatment systems is being recognized as a promising alternative to accomplish the Sustainable Development Goal No. 6 (SDG6) targets on ‘Safe Water and Sanitation’ and bringing health benefits to the people. This study aimed to investigate the current status of access to improved sanitation facilities in relation to the MDG7c and SDG6 in Thailand and comparing with other countries, including the effects of unsafely managed fecal sludge (FS) on the prevalence of diarrhea and liver fluke infections. The prevailing constraints and weaknesses were identified, and effective sanitation management measures to accomplish SDG6 targets were recommended. Based on data collected from 20 cities located in the north and northeastern regions of Thailand during the period of 2015–2020, the sanitation facilities data on conventional centralized systems and FS management facilities that affect the prevalence of diarrhea and liver infections were analyzed and interpreted using statistical and response surface methodology techniques. The findings showed that most of the surveyed cities have achieved the MDG7c targets, but 70% of the FS generated from on-site sanitation systems are still unsafely managed, caused by limited expansion of sewage systems for wastewater collection and conveyance (with inadequate operation and maintenance) as well as the financial constraints, especially in areas outside of urban neighborhoods. The effective sanitation management practices to accomplish the SDG6 targets were proposed such as increasing the capacity of sanitation facilities to be 55,000 m3/day/30,000 households, designing appropriate FS collection program and treatment technology, and providing more awareness programs for safe sanitation management and health risk protection.