UNC Water & Health: Inclusive and Innovative WaSH in the COVID-19 Era
By Katherine Isaf and Jasmine Burton of Wish for WASH
Much of our work, education, and social life has gone virtual over the past year in light of the COVID-19 pandemic. With these unwilled transitions, however, we may have discovered that virtual isn’t all bad, particularly in the conference world for work related to sustainability. From November 26–30th, more than three thousand of us attended The 11th Annual Water and Health Conference: Science, Policy, and Practice hosted by University of North Carolina at Chapel Hill’s (UNC) Water Institute and experienced the best of a well-executed conference-gone-virtual. Presentations were recorded and promptly uploaded within the day, meaning you could technically watch both of those parallel sessions at 13h00 that interested you. Chat boxes provided an approachable space for off-the-cuff questions, provocations, networking and thought exchanges, some of which were profound enough to be in a textbook or podcast script. And there were no days of travel, no nametags or lanyards, and no blazers! Not to mention the fundamental success of still having a space for practitioners, researchers, policymakers and scientists to gather and encourage our path forward as a water, sanitation and hygiene (WaSH) community during this unprecedented year.
The 2020 conference was anchored by major panel conversations covering timely topics such as WaSH during the COVID-19 pandemic response and Systemic Inequities in WaSH; similar to previous years, the rest of the conference time was filled with side events, virtual poster halls for drop-in conversations, and verbal presentations staring global, WaSH-related case studies, methodologies, and learnings. Perhaps one of the most unique benefits of the virtual conference setting was an ability to quickly zoom in and out between the big picture and individual perspectives, and to reopen chats from one verbal presentation on Monday and have the ability to efficiently compare it to a panel discussion happening on Wednesday to continue enabling the conference to provide intersectional value; participants were still able to walk away from the week having iteratively and consistently reflected on how science and practice plays into WaSH policy. And vice versa.
While a lot of information was shared over the week, there were also a few themes that sparked our curiosity at Wish for WASH as we found them woven across different levels and topics of discussion. Our following reflections stem from three themes that were most provocative and generative to us as WaSH researchers and practitioners operating at the intersection of innovation and inclusion:
- Are we aiming our efforts toward the right “end goal”?
- Are we collecting and utilizing diligent, accurate WaSH metrics and data?
- What solution mechanisms should we be creating and building upon to bridge the disparities within WaSH?
1. Reframing (or Repositioning) the End Goal
Over the course of the week, it became clear that there exists a general tension with the target objectives used to represent universal WaSH coverage. As strategic thinkers, we know that a clear and accurate end goal is vital to proliferating collective action particularly across sectors and cultures. The fact, therefore, that some of the most influential stakeholders in WaSH are uncertain about the effectiveness of the Sixth Sustainable Development Goal (SDG 6), the agreed-upon ‘Northern Star’ of sustainability success as determined by the United Nations in 2015, gives us reason to stop and pay attention to what was being stated as concern or as an opportunity to evolve our definitions of success in this sector.
During Wednesday’s panel entitled Addressing Systemic Inequalities in WaSH, Dr. Aaron Salzberg, Director of UNC’s Water Institute and moderator of the plenary panel, stated: “We have let the SDGs define success and have invested in vanity metrics: the number of people served rather than measures related to capacity, autonomy, [and] community.” As human centered designers and practitioners at Wish for WASH, it was apparent to us that the core message was that the targets defined in SDG 6 are perhaps no longer sufficient as goals since we have grown and evolved as a sector through a time of vast geopolitical and cultural change. Beyond solely metrics, our priorities and ways of working are changing and, therefore, the way we measure success should change as well. And panel members agreed with Dr. Salzburg’s sentiments. Hearing such a resounding voice, we were encouraged to begin looking for suggestions on how we can improve on this goal.
One source of insight was from a panelist from the same session who pointed out that the SDGs have led the sector to at times lowering our aspirational goals and have prohibited us from seeing leapfrog opportunities in rural areas, slums, and low resource communities that are often perceived to be more complicated settings with the lack of existing, reliable and cohesive WaSH infrastructure. While SDG 6 has been key in identifying areas lacking safe and hygienic WaSH standards, panelists discussed that this ‘baseline’ expectation may have also been guiding policy makers and practitioners to strive for “just enough” when more could and should be envisioned; these communities and contexts often offer a fresh slate to try new, more sustainable, and more equitable WaSH product and service models that would be much more complicated to adapt in settings that are burdened with existing or failing WaSH systems. As designers, we see generative potential in this concept. Some commentators from the audience also suggested that our global sanitation goal should simply be “safely managed service for all,” which would assume that safely managed is a step above and beyond the existing adequate and equitable access target written in SDG 6.2. These are incredibly significant and worthy thoughts for all of the players in the WaSH sector to consider as we plan programs and projects during this COVID-19 era.
A Special Session entitled Sanitation: New Pathways to Action and Scale encouraged us to think about how to design goals that better represent what households want from WaSH services. And in a fascinating case study presented by Action Against Hunger, they showed that the greatest indicator for whether a Cambodian household constructed a latrine was Equity and Affordability (followed by Social Norms and Peer Pressure). These speakers were demonstrating how imperative it is for WaSH scientists, policy makers, and practitioners to have an end goal that does not stop them short of true and aspirational livelihood changes for individuals. We will always be humbled by the reality of resources and transition, but let’s be sure not to truncate potential before we even begin.
2. Metrics, Measures, and Data
While we were still contemplating the opportunities to iterate our end goal (SDG 6), conference goers were posed with another sector-wide point of contention: the integrity of our metrics and data. Juxtaposed with the undisputed quality of the evidence-based presentations throughout the conference was a parallel, conceptual discussion on whether the metrics, and correlating data that the WaSH sector uses to track progress were in themselves relevant and reliable.
On one hand, attendees were informed about impressive scientific research, such as:
- the progress and limitations of using wastewater for COVID-19 surveillance and monitoring, which was directly inline with our Wish for WASH Smart Sanitation Poster session led by our colleague Emma.
- proof from microbial prevalence that intermittent water supply is unlikely to meet drinking water quality standards;
- retention rate analyses that supported or negated certain WaSH interventions.
At the same time, participants noted that “a lot of data is wrong,” which for us connected back to Dr. Salzberg’s reflection on vanity metrics. The session Addressing WaSH in High Income Countries also made a compelling case for why we need to counteract the lack of understanding and minimal disaggregation of data related to racial/ethnic minorities, resource-constrained, rural, and indigenous populations, as it makes it incredibly difficult to solve for the particular WaSH obstacles that these communities face in a way that was truly sustainable and inclusive.
This virtual conference provided guidance on and opportunities to discuss these raised concerns which we appreciated. Many spoke of measures involving willingness to pay, which is an influential indicator of autonomy and sustainability for WaSH products and services. Participants agreed that we want to see WaSH transitions remain in improved states 20+ years from now. To achieve this, we will need to measure and analyze data beyond WaSH conditions and practices, product attributes/instillations, and health education if we are aiming for true impact.
3. Innovations: Finance, Policy, and Methodology
Finally, we come to our last reflection: What solution mechanisms should we be creating and building upon to bridge the disparities within WaSH? This theme was especially dear to us as representatives of an organization with a central ethos of Human Centered Design. The conference placed a spotlight on the range of unaddressed WaSH realities, and with it, revealed a void ripe for finance, policy, and product/service innovations that can proliferate through the sector at large. In situations where communities have been “left behind”, in both high- and low- income countries, the parameters for WaSH solutions differ from those used where WaSH services already exist. As a rural WaSH moderator noted, non-traditional solutions are needed in non-traditional environments. At Wish for WASH when we hear “non-traditional”, we recognize that this implies that there are creative constraints that can drive innovation. Designing for “non-traditional” situations likewise has the potential to disrupt and transform status quo designs found in traditional settings. Ultimately, the conference advocated for these types of sustainable, inclusive, and innovative solutions, which was exciting for us to see.
The conference itself featured quite a few innovative solution mechanisms, including those in finance, products, and policy. The presentation entitled Finance for WaSH, for example, did an excellent job displaying finance-related approaches to effectively reaching underserved WaSH consumers. CACTUS (Climate and Costs in Urban Sanitation) was presented as a first-of-its-kind standard method for reporting costs of urban sanitation; this in turn offers new data to the table for better and more informed decision making and designs. In this same side event, we heard about the popular Impact Bond and its applicability to a sanitation marketing scale-up in Cambodia that had originally plateaued at reaching 73% of the target population. And concerning the population, directly, a private sector lens during the final conference panel inspired attendees to find ways to reframe the narrative of low-income populations from being WaSH program beneficiaries to an untapped customer segment in the Sanitation Economy; another panelist further strengthened this point when reminding us that “being poor is very expensive.”
Lastly, as an organization that was founded on the principles of product design, we were thrilled to see a number of presentations mention the Human Centered Design process (as seen in the CFM Design Workshop photo) and to see the explicit call to action from the WaSH in Healthcare facilities group surrounding product and service innovation. And as always, it was fantastic to see the work happening related to Women in the Sanitation Workplace and Menstrual Health policy.
Final Thoughts
The seamless virtual platform that UNC’s team created within a matter of weeks gave presenters and participants the minds and means to support, question, comment, and collect information to their hearts’ desire. A host of material was disseminated and critically discussed in a way that was generative and creative. This aligned with our Wish for WASH values, and we are excited to be amongst those that are working to emerge from this era to design, research and educate more effectively to truly drive lasting change that leaves no one behind.
