World Health Organisation (WHO) Consultant on Environmental Health
A health profile of East Timor prepared in 1998 showed that 52% of the population did not have access to the safe drinking water, and 62% of the population did not have access to sanitary disposal of human waste. A survey of water and sanitation services found that there is a low level of knowledge among the people of the importance of safe drinking water and sanitation for good health.
Urban and rural sanitation needs are always different and they should be viewed separately. On-site sanitation technology can provide appropriate and affordable means of sanitation to the households in rural communities of East Timor while a sewerage system seems to be a single option for collective disposal of wastewater in the city of Dili, which has gathered a lot of potential for rapid urbanization and increased wastewater generation in the near future. On-site sanitation facilities in the congested urban areas may have different problems with the limited land available for collection or disposal of waste, contamination of the water points in close proximity to the toilets, effluent over flowing freely to the surface drains, and the inadequacy of the system for increasing daily use.
Wastewater is generated from a variety of domestic, industrial, and institutional activities. The flow of uncontrolled or unconfined wastewater may pollute the surface or ground water where it is also being used for drinking purposes. Faecal contamination of drinking water, which is generally due to open defecation and the uncontrolled flow of wastewater, is responsible for several bacterial, viral, protozoan, and parasitic infections and communication of diseases such as diarrhoea, dysentery, cholera, giardiasis, and enteric fever. The Culex pipiens mosquito, the vector of filariasis, usually breeds in sewage water.
Pit latrines or septic tanks are generally built in rural settlements, however, around one third of the people in East Timor are still practicing open defecation. Around 15% of the population use public or shared toilets. Most of the toilets constructed by the international agencies have not been greatly accepted by local people.
It is necessary to develop and promote a range of options for on-site sanitation that would be appropriate to the varying site conditions in different rural communities, as well as being acceptable and affordable to the people. Depending upon affordability, latrines with single or double-pits with offset pour-flush facilities would be most suitable for high land areas. Pit linings may be necessary. A soakpit or a drainage trench to digest the effluent overflowing from the tanks should always follow construction of septic tanks. In low land areas with shallow groundwater tables, raised pit latrines should be promoted and groundwater should be monitored for contamination. A separate soakpit or trench can also be built as a drain for household grey water.
Hygiene education programs can help to motivate people to build and use their own latrines. A “people centred” approach to planning and implementation of sanitation programs involving community participation will help greatly to raise demand for sanitation, and ensure full acceptance, support and effective use by the public of the systems built. A large number of local and international NGOs are working in East Timor. Networking at central and district levels with NGOs working for water supply and sanitation can enhance the coordination of NGOs and government. Various awareness, education, and training programs for the promotion of hygiene and sanitation could be effectively developed and conducted in the communities through the initiation and support from those NGOs.
Dili has great potential for rapid growth and development in the near future, as it will be the capital city of the new nation of East Timor. It may attract a lot of people migrating from different parts of East Timor.
There is currently no sewerage system in Dili and even the modern houses have septic tanks. Pit latrines in low lying areas and septic tanks without soakpits are causing pollution of shallow groundwater and contaminated surface runoff to drains. The widespread flow of wastewater may give rise to the wetland conditions increasing numbers of disease vectors.
Drainage facilities for the surface water runoff in urban towns including Dili, are carrying a part of the wastewater flowing out of the septic tanks and from flooded pit latrines during heavy rains. Those drains are inadequate in capacity and are open at several locations. The rehabilitation of those drains, upgrading their capacity and providing covers where necessary would be one of the very important steps towards minimizing environmental pollution in the urban areas of East Timor. The existing water supply system in Dili will soon be rehabilitated and upgraded.
A sewerage system could be the best option for Dili and could provide flexibility to accommodate increasing wastewater flows over the next 10 to 15 years. At the initial stage a sewerage system could be constructed for the core area of Dili with future provisions for extensions to its outskirts as and when it is affordable.
A sewerage system consists of pipeline connections (sewers) to households for the collection and transport of the wastewater to a treatment site. The degree of contamination of wastewater is greatly reduced by various treatment processes. In Dili, as the climate is hot, sewage could be economically treated in waste stabilisation ponds. Currently such ponds are used on a small scale to treat the sewage collected from the septic tanks by a private company working for UNTAET in Dili. Following treatment, the final effluent has a very low level of contaminants and can be safely disposed in the sea.
In South-East Asia, the per capita cost of sewer connection in urban areas in 1985 varied from US$45 to US$400 with a median cost of approximately US$80. Assuming this is still applicable for Dili today, with a population growth rate of around 3%, an approximate capital cost estimation for the system to the projected population of 214,100 in 20 years (based on the current population of 118529) would be around US$17 million. If the construction of the sewerage system is planned in two phases, the first phase for central Dili and the second phase extending beyond central Dili, the phase-wise cost of the construction could be US$10 million and US$7 million respectively. The high capital cost associated with a sewerage system could be justified in terms of the long-term health benefits that could be achieved by reducing wastewater related diseases.
The need for a sewerage system in Dili should be prioritised, and advocated for among the people of Dili/East Timor, and to the various technical and administrative divisions under ETTA including the Department of Health Services and Division of Water and Sanitation Services, external support agencies and NGOs/INGOs concerned. This could be achieved through organising a Seminar/Workshop to raise the profile and stress the importance of having a sewerage system in Dili
Water supply and sanitation programs are complementary, and should always go hand in hand. Sanitation and wastewater management usually receive less attention compared to other development activities. However it is one of the basic service needs of the community and the lack or mismanagement of such a facilities has an immediate health impact.
East Timor will soon be independent. In this respect the capacity building processes of the government and non-government organisations should also identify the tasks of formulating new strategic plans and initiating manpower training for wastewater management and drinking water supply systems. Hygiene education can bring awareness and motivation among the people to demand for better sanitation. Participatory processes for hygiene education and awareness prior to the physical implementation of sanitation facilities are always helpful in achieving acceptance and use of the systems, by the people in a long run.