In Nepal there is at the moment a lot of discussion about the treatment of waste water. It is said, that because of the use of proper toilets child deaths are minimized. However now the problem arises what do we do with the waste water from these toilets? There is a lot of discussion but there aren’t yet sustainable solutions. See the following paper about this discussion:

Hospital management took the initiative for this waste water plant. It was proposed to the local Mayor and he was enthusiastic about it. He called the local Advisory Board and this was discussed. They were very positive about this project, that it should proceed. As the hospital doesn’t have the space to locate the wetland, the local authorities made it possible to use a part of the land of the Forest Department. The so called “Forest User Group” will assist to implement this project and take care of the distribution of the cleaned water. Besides this the F.U.G. has agreed to assist the Municipality in promoting waste water cleaning plants for other institutions in Tansen. They are very motivated as most members are mothers. They take care of the health of the family and they see the results of the use of polluted water.

Municipality chief wrote a letter stating the support of the municipality (see below)  

In Nepal, the United Mission Hospital Tansen hospital is seen as a forerunner to improve its health care. It won the following prizes:

– Best hospital in Nepal given in July 2012 by the Minister of Health in the name of the medical magazine: “Swasthya Kabar Magazine”
 – In November 2012 it received the “Healthcare Leadership Award 2012” of the “Knowledge Resource Development & Welfare group” Delhi for “Outstanding Contribution in Promoting Inclusive Healthcare”.

– In 2014 the “Dixa-Daxa Sewa Puraskar 2014” award was received from the “National TB Centre on international TB day” for “the spectacular service of the hospital in view of the TB checks.” This was the second time this award was won by the hospital

The hospital is well known in Nepal and managers of other hospitals come regularly to Tansen to look at the improvements the hospital makes. The AMDA hospital from Jhapa (Nepal) sent the following mail:

“ Dear Dr. Karrach,

Namaskar and warm greetings.

We are thankful on the kind cooperation of your and your team that exposed during the visit of AMDA SCWH team in your esteemed hospital. We are highly influenced with the efficient management of each unit as well as the complete cleanness of the hospital inward/outward premises. I am personally much impressed the waste management. In
this regards considering our concern about incinerator, we are grateful that you share the design with details.

In coming days, we hope to have such coordination meeting for mutual cooperation.

Thank you.

With Regards,

Achyut Sapkota
Senior Officer (Amin/Finance)”

The hospital will promote and show this waste water plant to other interested parties.

The chosen solution is sustainable because septic tanks are known in Nepal and local personnel is able to maintain the system. The MBBR is basically free from maintenance. The inflow and outflow pipes have to be checked if there aren’t obstructions.

By choosing septic tanks and a MBBR a sustainable solution is found in the treatment of waste water that easily can be copied elsewhere. The advisor of the hospital of this project is willing and capable in giving advice to other parties if so requested. Therefore, this project will be an example to the discussion about the waste of toilets and can give a boost to the implementation of more waste water systems in Nepal.