As Haiti tries to improve its people's quality of life and boost tourism, there is one important issue that remains to be solved: poor sanitation infrastructure.

Lack of toilets and a poor sanitation system facilitate the spread of diseases, intimidate foreign visitors, and affect the quality of life of many Haitian people. According to Unicef (2010 report) only 10% of rural Haitians and less than 25% of those in cities have access to adequate sanitation facilities, by far the lowest coverage in the Western Hemisphere.

Building a modern sewer system would cost billions of dollars; however, a bigger problem for Haiti would be the maintenance cost of such system, which is exuberant. Besides, it would take a reliable energy provider in order to keep the system functional.

In the meantime, there are some grassroots efforts taking place

Sustainable Organic Integrated Livelihoods (SOIL), a small non-profit, has been working for the past six years on coming up with sanitation solutions while building an economic model that can be profitable and attractive for local entrepreneurs.

"In thinking about human rights issues I realized that the most severe human rights issue in Haiti is poverty and the fact that people don't have access to the basic services like sanitation," says Sasha Kramer, PhD in Ecology and Co-Founder of SOIL.

Sasha and seven other partners founded SOIL in 2006 to provide sustainable sanitation solutions for Haiti.

SOIL, in partnership with a group of American designers called "Resource", came up with a few designs for public toilets and portable household toilets called EcoSan. These wooden toilets are built to separate the solid from liquid wastes. The end users would cover the wastes with special dry materials to remove any odor.

Building a sustainable economic model for sanitation services

SOIL has tried to use different economic models to see which one would really support this type of project. Over the years they realized that the only way this will become an economically viable project is for people to buy their toilets and pay a monthly service fee for waste collection.

Besides numerous public toilets provided by SOIL to various communities, 35 families in Port-au-Prince are using the EcoSan household toilets and paying a monthly service fee of 100 Haitian Gourdes for weekly waste collection.

SOIL employees collect the waste and transport it to composting sites where it is treated for 6 months so that all potential pathogens are destroyed. This process transforms waste into a valuable fertilizer that SOIL sells to nurseries, garden stores, NGOs, and street resellers.

A similar pilot project runs in Cap Haitian. SOIL provided 150 families with toilets and free service for three months. Beginning in March, some of them may choose to continue using the toilets for a monthly service fee.

Eventually SOIL wants to turn this model and knowledge over to local entrepreneurs that could extend this project further. Based on SOIL's calculations, the break-even point would be to service between 1000-1500 households that would pay the monthly fee.

Sasha Kramer notes that people in Haiti are not used to paying for sanitation, and it would take an extensive marketing campaign to change that.

"Using public health angle I don't think works very well. People pay for certain services because they are trendy. We need to look at dignity angle of having a toilet. One of the main reasons that we found for people to want to have a household toilet is because when they have visitors come, they want to be able to offer them a toilet and if they don't have one it's very embarrassing," said Kramer.

Getting the government involved

The part of the project that didn't turn out to be fully sustainable is the waste treatment. So far, SOIL was able to treat and sell 15 tons of compost over the last 3 months at 100 Haitian Gourdes per 5-gallon bag.

Even though the demand for compost is higher than the organization can provide, waste treatment did not prove to be profitable. Compost sales only cover about 75% of treatment expenses and will not be attractive for the private sector. SOIL hopes that the government will take over this process.

"Because it's not profitable, it would be hard to get private business in it. But, because it's much cheaper than any of the other options it's a very good option for the government to provide waste treatment services at a lower cost," says Sasha.

IDB, the World Bank and other donors have granted millions of dollars for Cholera prevention.

"I think that a lot of this money goes towards water instead of sanitation, because water is much easier to implement than sanitation. I'm afraid that although there was a lot of money pledged towards cholera prevention in Haiti, I don't think that money is going to go towards building centralized sewer systems. They are extremely expensive to implement,” noted Sasha Kramer.

In December 2012, UN Secretary-General Ban Ki-moon launched a $2.2 billion initiative to eradicate cholera in Haiti over the next decade, after an epidemic killed thousands of people in 2011 and been blamed on UN peacekeepers. "The main focus is on the extension of clean drinking water and sanitation systems," Ban said. The money have not been raised yet.