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Thanks for your questions which has triggered a great confab here at WaterAid London.

We will dredge up a piece of research we know of relating to hook-worm on slabs, done in Tanzania and post shortly.

But this triggered an interesting discussion. There are two issues really with the washable or not debate. The one is the pathogens debate, the other is the cleanliness in terms of look and smell. Bottom line is, nothing except glazed ceramics and plastics are totally impermeable. Even a really great concrete slab when not kept clean will soak up urine etc and become smelly.

But let’s look at each of these in turn:

Pathogens .... apart from hook worms, most other pathogens are to be ingested. So, putting the ease of cleaning issue one side for a moment, does this mainly become an issue user behaviour? This made us think about a number of our CP hygiene promotion campaigns, some of which go to the extent of promoting short nails and the wearing of shoes at all times, even when bathing and going to the toilet. So assuming we achieve that, we theoretically avoid hookworm. Most people will not touch the floor of their toilet unless cleaning it and frankly, combined with handwashing this should not be too big an issue.

But that then raises the question about smell and general cleanliness, which in my mind is a bigger issue. We want people to want to use their toilets, for faecal matter to not be a taboo, to be seen as a resource. A clean non-smelling toilet must be part of this, surely? There are the down the hole smells, there are the slab smells. Ventilation or soil&ash are solutions to the hole smells, washability is a part solution for the slab smells.

So for me the issue is what does a country want to achieve and do they need to achieve both the above using the same strategy. I think this is a similar debate to the CLTS / Sanitation Marketing debate. Minimum standard = traditional safe slab. Aspirational marketing = washable slab? Basic sanitation campaigns can promote the construction of a toilet and set a minimum standard of a latrine with a traditional safe slab. This can interweave with national and local level sanitation marketing for improved latrines / latrine products to introduce the aspirational aspects.

Does that make sense?

Will fwd research ASAP.

Erik