Adequate housing is a human right. Unfortunately, 1.6 billion people around the world do not have access to adequate housing and many vulnerable communities have areas in which homes are not only inadequate but can actively contribute to spreading or promoting diseases. For instance, in the current pandemic, built environment-related risk factors like overcrowding and poor indoor ventilation can exacerbate the spread of COVID-19. An estimated 3 million children die each year from parasitic infections associated with diarrhea, malnutrition, and micronutrient deficiencies, and diarrheal disease is the second leading cause of death globally for children under 5 years old. Vulnerable communities, in particular, are subject to high risks of waterborne diseases linked with low-quality, substandard housing and sanitation infrastructure in addition to a lack of education on hygiene and disease prevention.

Bangladesh is a riverine country with about 700 rivers and tributaries flowing across the country into the Bay of Bengal making most of the region prone to floods. Bangladesh is also known for a heavy monsoon season from June to September which, in the last few years, has been lengthening due to the impact of climate change. Monsoons present a recurrent challenge, and low-income households and communities remain ill-equipped to face them due to poverty and the associated difficulty of investing in their homes. The dirt plinths, which 67.8% of the population in Bangladesh live on, quickly erode in heavy rains and under omnipresent vermin, contributing to the cyclical nature of inadequate housing for low-income families. In the region of Savar, Bangladesh many villages suffer from seasonal flooding, which brings contaminated water and liquid waste into roads, walking paths, and living environments. Compacted dirt flooring makes it easy for opportunistic parasites and bacteria to proliferate and cause illness. Because the families who participate in our project survive on only $100 of income per month, they are unable to afford the installation of improved flooring that could help prevent disease.

Mud to Mortar delivers a unique intervention that helps address the above-mentioned challenges. The complete replacement of dirt floors with a simple concrete floor assembly in the homes of vulnerable families prevents diarrheal disease and other life-threatening illnesses. Since 2014, Mud to Mortar has aimed to provide long-lasting, durable, and easily cleanable floors as a strategy to improve the sanitary conditions of the home, reduce the risk of building collapse, and ultimately increase the resilience of vulnerable families in the region of Savar, Bangladesh. This cost-effective, sturdy flooring is easily cleaned and maintained, and is not at risk of being damaged by vermin, other pests, by thieves digging from under it, erosion from rain, and floodwaters the way dirt floors are. The participating families and community members attend workshops for best sanitation and hygiene practices, increasing the intervention’s impact on health outcomes.

The families are selected using eligibility criteria approved by the Association of Development for Economic & Social Help (ADESH), our local implementing partner, to ensure that we focus on the most at risk and vulnerable households. The selection criteria includes ensuring that the families have an adult female living within the home, have on average 400 sq. ft. of indoor floor space, agree to participate in the construction process, and have ownership of the home. This project can provide truly impactful support to the local population, particularly women and children, who often are disproportionately affected by dirt floors and disease.

The design of the floor is radically simple - a concrete assembly was designed to combat the wet conditions of the area. It has evolved through 4 phases as a refinement of the local construction methodology to achieve the most structurally appropriate yet cost-effective concrete floor assembly. While keeping the home intact, the existing dirt perimeter and plinth are excavated then replaced with the concrete floor. ARCHIVE and ADESH have worked closely with the local masons on construction logistics and efficiency to enable a single mason to oversee the construction of 4-5 homes at once, keeping the costs low. The exact assembly of the floor has changed by phase based on input from the families, ADESH, the local masons, Grimshaw Architects, who collaborated with us on Phase 2, and the Bangladeshi Housing and Building Research Institute. The improved floor has been designed to strike the balance between durability, strength, and cost and is currently at $1.21 per square foot with a strength of 8,000 PSI and tested to last 30 years. Masons and their assistants have learned a new construction method that they are able to promote within their community. The new floor has been shown to save women, who are typically expected to keep the home clean, from spending on average 20 hours each week cleaning and maintaining the dirt floors. This enables women to dedicate their time on more economically productive activities or on their children.

Our dual intervention of flooring improvement plus education creates long-lasting change. Our approach helps people move out of extreme poverty over time because their families are healthier, so children are able to attend school consistently and parents are able to go to work more days of the year, allowing their financial situation to improve over time.

The advantages of the flooring upgrade extend beyond simply being an effective way to decrease diarrheal diseases in the household. These floors provide additional economic benefits by:
1. Minimizing the medical costs associated with parasitic and bacterial infections
2. Significantly adding to the value of the home and thereby access to credit and loans
3. Increasing the community’s resilience against recurrent challenges, such as flooding, cholera outbreaks, or other hazards
4. Providing an opportunity to boost families’ knowledge on sanitation and hygiene concepts that are simple and cost-effective to implement as well as teaching new best-practices—for example, the concrete floors are easily cleanable with water and disinfectant
5. Increasing overall health literacy and improvement in sanitation and hygiene behavior and practices in the community

These reasons underpin ARCHIVE Global’s vision of using design interventions to prevent disease transmission and to promote health literacy and economic development in vulnerable communities worldwide. One simple improvement to houses with dirt floors offers the opportunity to alter the inadequate housing conditions that increase parasite infestations and the subsequent diarrheal disease incidences in children. Currently, we are planning for Phase IV of this project following a highly successful pilot program and a scaling up of the project in Phases I, II, and III.

Credits:
- ARCHIVE Global - Project Officer - Charlotte Burch
- Grimshaw - Archiectural Designer - Mehnaj Tabassum
- Grimshaw - Architectural Designer - Max Dowd
- Grimshaw - Associate - Eric Johnson
- ARCHIVE Global - Interim Managing Director - Riksum Kazi
- ARCHIVE Global - Research and Grants Officer - Jimi Patel
- ARCHIVE Global - Director of Projects and Development - Sarah Ruel-Bergeron
- ADESH - Executive Director - Subrato Dey