Developing an integrated sustainable sanitation system for urban areas: Gaza strip case study

A vertical flow (reed bed) constructed wetland was used for treating bio-solid and gray water. The results present a positive performance in treating the bio-solids and well-stabilized accumulated organic material in the bed formed fertile soil. Moreover, using vertical flow reed bed of liquid waste treatment showed removal of around 70% of organic matter indicator Biological Oxygen Demand (BOD5) and Chemical Oxygen Demand (COD). The Fecal Coliform (FC) removal was around 2 logs (99.9%) with a retention time of less than two days. The effluent can be used in agriculture or groundwater recharge. A semi-dry toilet followed by anaerobic/aerobic units is in planning to be coupled with an existing system. The system mainly depended on separating of the human excreta from the urine and gray water. The two separated fractions will be treated in vertical flow reed bed to produce organic fertilizer and reclaimed water for reuse. Such systems could be a suitable solution for wastewater problems in Gaza strip and similar regions. The designed and planned system integrated environmental and technical sound approaches with socio-economical aspects. In addition, the designed system implemented the idea of a natural and closed circle of water and nutrients “from food to food”

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Beitrag zur Entwicklung nachhaltiger Sanitärtechnik in Schwellenländern

Sanitation is of special concern to the international community, particularly in emerging countries. Lack of sanitation is one of the world's leading causes of disease and child death. Worldwide, current progress on sanitation is not sufficient to meet the target of Millennium Development Goals and the sanitation crisis is expanding. Currently, conventional sanitation approaches, both water-based and dry-based, are not designed for effective recovery of valuable resources. Consequently, the economic and environmental sustainability of these approaches may still be questionable. Therefore, sanitation management requires an urgent paradigm shift based on the concept of sustainable sanitation. One of the possible approaches to cope with the sanitation crisis is a resource-oriented approach that considers not only protection of human health and the environment but also closes loops on water and nutrients. Through this thesis, a resource-oriented sustainable sanitation (ROSS) module was designed and developed to reuse resources and recover nutrients from wastewater at a household level. The two main wastewater streams, mainly blackwater and greywater, are collected separately. The blackwater passes through a solid-liquid separator, where blackwater solids are separated and stored in a filter bag until a suitable time for further treatment. The blackwater liquid collected from the separator flows through a tank for nutrient adsorption by charcoal before entering a subsurface flow wetland for further purification. The treated effluent can be collected and stored in a storage tank before reuse in irrigation. Excess effluent from the storage tank flows to another tank for groundwater recharge. The blackwater solids and charcoal can be treated via lactic acid fermentation and composting for producing a Terra Preta-like substrate. Similarly, solids organic wastes may also be treated and added to the Terra Preta-like substrate before reuse in aquiculture. Based on the concept of a ROSS module, two decentralised prototypes were implemented and realized in two households in the Gaza strip, depending on locally available resources and materials. The workability and efficiency of the module were investigated by monitoring one prototype. The module products, including the treated effluent and Terra Preta-like substrate, were inspected through testing composite samples collected in two rounds for the effluent and one round for the substrate. The finding of the sampled effluent revealed that the module was capable to removed 94.1% of total suspended solids, 78.9% and 86.1% of biological and chemical oxygen demand, respectively, and 99.4% of faecal coliform. The sampled substrate demonstrates acceptable properties as compared to the good compost produced from faceal materials. The total nutrient content and organic matter of sampled substrate were 2.373%, and 74.93%, respectively. The lead and cadmium concentrations were below maximum restricted limits and no faecal coliform was measured in the sample. However, the parasitic worm “Ascaris Ova” was noticed in the sample. The presence of this worm may limit the use of the substrate in planting vegetables. Moreover, following good hygiene practices, e.g., hand washing and wearing hand gloves, are highly recommended when using such products.Das Sanitärwesen ist für die Weltgemeinschaft von besonderer Bedeutung, insbesondere in Schwellenländern. Der Mangel an Sanitäranlagen ist eine der Hauptursachen für Krankheiten sowie die Kindersterblichkeit. Die bisherigen, weltweit erreichten Fortschritte sind nicht ausreichend, um die Millenniumziele der United Nations zu erreichen. Tatsächlich weitet sich die Krise im Sanitärwesen sogar noch weiter aus. Konventionelle Wasser- und Trockentoiletten wurden ohne die Rückgewinnung wertvoller Ressourcen entwickelt. Folglich ist die ökonomische und ökologische Nachhaltigkeit dieser Ansätze fraglich. Das Sanitärwesen erfordert einen dringenden Paradigmenwechsel auf Grundlage des Konzepts nachhaltiger Sanitäranlagen. Eine vielversprechende Vorgehensweise zur Bewältigung dieser Krise im Sanitärwesen ist ein ressourcenorientierter Ansatz, der nicht nur dem Schutz der Gesundheit des Menschen und der Umwelt dient, sondern auch der Schließung des Wasser- und Nährstoffkreislaufes. In der Arbeit wurde ein ressourcenorientiertes nachhaltiges Sanitäranlagenmodul (ROSS, englisch: resource oriented sustainable sanitation (ROSS) module) entwickelt, dass der Wiederverwendung und Rückgewinnung von Nährstoffen aus dem Abwasser von Haushalten dient. Die beiden wesentlichen Abwasserströme, Schwarz- und Grauwasser, werden separat gespeichert. Das Schwarzwasser wird anschließend durch einen Separator geleitet, um Feststoffe vom Schwarzwasser zu trennen und in Sackfiltern für eine gewisse Zeit zur weiteren Verarbeitung zu speichern. Das Schwarzwasser, das von Feststoffen getrennt wurde, fließt nun durch einen Tank zur Nährstoffadsorption, der Holzkohle enthält, bevor es in ein unterirdisches Feuchtbiotop zur weiteren Klärung fließt. In einem Tank wird das behandelte Abwasser gelagert, bis es zur Bewässerung wiederverwendet werden kann. Das behandelte Abwasser fließt vom Speichertank zu einem unterirdischen Grundwasserneubildungstank. Die Feststoffe aus dem Schwarzwasser und die Holzkohle können durch Milchsäuregärung und Kompostierung für die Herstellung von Terra Preta ähnlichem Substrat behandelt werden. Ähnlich können organische Feststoffe behandelt und zu dem Terra Preta ähnlichen Substrat hinzugefügt werden, bevor sie in der Landwirtschaft wiederverwendet werden können. Basierend auf dem Konzept des ROSS module wurden zwei dezentrale Prototypen implementiert und in zwei Haushalten im Gazastreifen in Abhängigkeit von lokal verfügbaren Ressourcen und Materialien realisiert. Um die Machbarkeit und Effizienz des Moduls zu untersuchen, wurde ein Prototyp anhand einiger Qualitätsparameter in zwei Runden für das behandelte Abwasser und in einer Runde für das Terra-Preta ähnliche Substrat geprüft. Das Ergebnis des untersuchten behandelten Abwassers ergab eine Trennung von 94,1 Prozent der Schwebstoffe, von 78,9 Prozent bzw. 86,1 Prozent des biologischen und chemischen Sauerstoffbedarfs bzw. 99,4 Prozent der Fäkalcoliforme. Das Substrat zeigt im Vergleich zu Kompost aus Fäkalien akzeptable Merkmale auf. Der Nährstoffgehalt und organische Substanz der untersuchten Substrate liegt bei 2,373 Prozent bzw. 74,93 Prozent. Die Blei- und Cadmiumanteile waren unterhalb der Höchstgrenze und keine Fäkalcoliforme waren nachweisbar. Es wurde jedoch festgestellt, dass parasitäre Würmer wie Ascaris Ova die Nutzung für das Anpflanzen von Gemüse limitieren können. Ferner sollten hygienische Vorsichtsmaßnahmen, wie Händewaschen und das Tragen von Handschuhen, bei der Nutzung solcher Produkte berücksichtigt werden

تقدير الحقن الصناعي ونتائج النمذجة الرياضية الخزان الجوفي الساحلي في شمال وادي غزة

Gaza coastal aquifer faces huge crises of the water resources scarcity and contamination by seawater intrusion. Accordingly, real concerns for planning, development, and management of available resources became so required to alleviate of such crises. This could be by searching for new additional cost effective resources. The artificial recharge using both the stormwater and the reclaimed wastewater, for instance, is one of these new alternative resources. The main aim of the study is primarily to study the possible optimum management scenarios for study area aquifer by adopting the artificial groundwater recharge options. The first part of the research illustrates the artificial recharge background, needs, history, and sources in Gaza strip; the numerical methods for groundwater management; and Optimization-Based Groundwater Management Models. Thus possibly put our hands on the major and minor factors that are necessary to achieve the artificial recharge assessment and groundwater modeling. The second part of the study describes the study area topography, geology, soil stratification, hydrology, hydrogeology, and justification of selecting the study area. Therefore, a clear background could be built upon the area. Third part presents the two approaches which were used to record the groundwater responses once artificial recharge options were imposed. Three different locations for the artificial recharge facility were suggested in the study area with changing the recharged quantity with three different ones 0.5, 1.0, and 1.5 MCM/year for each location. The first approach was based on the simulation model alone and the second based on the simulation/optimization model with application to some parts in the Gaza aquifer. Through the first approach, 3D coupled groundwater flow and transport model CODESA 3D (simulation model) was generated by conceptualizing the existing aquifer through constructing the 3D mesh using a pre and post processing software Argus One based upon the finite element method. Based upon different hydrological conditions for year 2008, the simulation model were generated for 1 year transient state. The current wells production was continued with the same pattern for 10 years more. The results for both scenarios were compared. The average hydraulic head at all wells after 10 years (2018) was reduced by about 9%. Moreover, based upon the simulation results, the most feasible location was identified with the effective quantity to be recharged. However, the simulation model alone can't confirm the optimum location and the optimum quantity to be recharged; therefore, the optimization model is needed to be coupled with the simulation model. Through the second approach, the simulation model CODESA-3D was linked externally with the management (optimization) model using Genetic Algorithm (GA) technique. The optimization model aims to raise the water table by managing the groundwater pumping under various hydrological constraints. However, the study included only constraints on the volume of water extracted and the quality of water produced. Two optimization models were formulated, the first multiple- (two-) objective management model is developed for maximizing sustainable water withdrawal from the aquifer for beneficial uses and for controlling the salinity of the water withdrawn simultaneously. Moreover, no alternative options/sources have been taken into account, i.e. no artificial recharge; therefore, the model solution came up with a new optimal spatial distribution of pumping from the existing wells only. This new pumping pattern is tested by the simulation model for one year transient state. The total pumped water reduced by 1 % only and the average improvement in hydraulic head at all wells was 10%. While the second model was similar to the management objectives of the first model with adopting the artificial recharge as a new alternative source. The application of model 2 identified the first suggested location as the optimum recharging location. Moreover, the optimum allowed pumping quantities increased among the existing situation by 126%, 151%, and 176% when 0.5, 1.0, and 1.5 MCM/yr were artificially recharged respectively

A simulation/optimization approach to manage groundwater resources in the Gaza aquifer (Palestine)

A decision support system based on a simulation/optimization approach has been developed and applied to the Gaza Strip coastal aquifer (Palestine) to manage sustainable aquifer development under effective recharge operations and water quality constraints. The paper describes model development and simulation results