Sanitation policies under scrutiny in Martinique

An opinion piece by Francis Carole, president of PALIMA and territorial advisor for Martinique, raises concerns about sanitation policies over the past fifty years. The article highlights ongoing risks, inequalities, and the need for better responses to ensure public health and environmental protection.

Public water service and sanitation connections

According to the Office of Water, 42.5% of customers of the public potable water service were connected to collective sanitation in 2022. Around 57% were not connected, with the number of individual installations estimated at about 73,000 in 2022 and approximately 75,000 in 2025.

Incomplete mapping of individual sanitation systems

The 2025 situation report indicates that a cartographic diagnostic of individual sanitation had been carried out on only about 40% of the territory. This does not mean that only 40% of the devices had been inspected, but rather that their location and the pressures they exert on the environment remain poorly documented.

High non-compliance in individual sanitation

According to the DEAL, 90% of the individual installations checked are non-compliant, and only about half of the park had been checked. These estimates do not describe the entire park or the share of households discharging their wastewater directly.

Uncertainty about households without any sanitation system

A question remains: how many households have no system at all? An estimate from 2011 suggested that about a third of non-connected subscribers used no sanitation method, but this data is outdated. An updated measurement, commune by commune, is essential.

Shortcomings in collective sanitation systems

Of the 74 public stations examined in 2023, 38% presented shortcomings in self-monitoring equipment and 19% required heavy rehabilitation. These two categories may overlap, and the dashboard of the SDAGE published in 2026 highlights weaknesses in local compliance rates in 2024.

Varying levels of sanitation connections across regions

The proportion of subscribers connected to the collective network reached 52% at CACEM, 39% at the South Space and 32% at CAP Nord in 2022. Within the same intercommunality, the gaps can be much more marked: 70% at the Trois-Îlets, against 4% at Rivière-Pilote.

Health risks of untreated wastewater

Untreated wastewater can carry bacteria, viruses and parasites, which can lead to gastroenteritis, infectious diarrhea, certain parasitoses and, under particular circumstances, hepatitis A. These pathogens can also promote the circulation of antibiotic-resistant bacteria, particularly affecting children, the elderly and vulnerable people.

Global impact of poor sanitation

The World Health Organization estimated that approximately 564,000 deaths worldwide were attributable to insufficient sanitation in 2019, mainly due to diarrheal diseases. A 2022 meta-analysis in The Lancet found that sanitation improvements reduced the risk of diarrhea among children in low- or middle-income countries by about 24%.

Historical sanitation issues in Martinique

A 1984 study described an intestinal schistosomiasis focus in Saint-Pierre, linked to a non-operated wastewater basin. While this episode was localized and had low epidemiological impact, it highlights the long-standing sanitation challenges in the region.

Environmental consequences of wastewater discharges

Wastewater discharges can introduce nitrogen, phosphorus and organic matter into rivers and coastal waters, promoting eutrophication, algal growth and reduced oxygen levels. These changes can harm biodiversity, fishing and coastal uses.

Pressure zones identified in 2025 report

The 2025 situation report of the hydrographic basin identified six coastal water masses subject to high nitrogen pressure from collective sanitation and nine river and four coastal water masses with high pressure from non-collective sanitation. These areas require priority monitoring and protection.

Costs and challenges of individual sanitation

Individual sanitation systems can be expensive, with installation and operation costs over fifteen years estimated at around 18,750 € for a microstation, 15,050 € for a compact filter and 10,200 € for a vertical sand filter. These figures are based on 2020 data and do not include current prices or guarantees of lifespan.

Maintenance and reliability of sanitation systems

In addition to initial costs, individual sanitation systems require regular maintenance, emptying, checks and replacement of materials. Their reliability also depends on factors like terrain, soil type and the availability of professionals and spare parts.

Cost comparison with collective sanitation

The average rate for collective sanitation in Martinique is 3.11 € TTC/m³, which would amount to about 7,464 € over twenty years. This does not include connection costs or future rate increases and cannot be directly compared to individual system costs.

History of sanitation in Martinique

Sanitation works in Martinique have a long history, involving municipalities, syndicates, intercommunalities, the State and various organizations. A historical investigation is needed to determine who decided, funded, built and maintained the sanitation infrastructure.

Estimated costs for upgrading sanitation

A 2010 state audit estimated the need for bringing sanitation up to standard at 650 to 850 million euros. The 2022-2027 measures program planned around 81 million euros for collective and connection operations and 40.52 million for non-collective sanitation.

Need for transparency and accountability

The expected balance must compare the sums paid, the completed works and the actual health and environmental results. The UN has recognized the human right to water and sanitation since 2010, and the WHO recommends a risk-based approach to ensure safe sanitation for all.

Urgent action needed

The urgency lies in avoiding avoidable health risks and preventing environmental degradation. Heavy rains and floods can worsen overflows and the spread of contaminated water, requiring immediate action in high-risk areas.

Demand for comprehensive evaluation and reform

A public and independent assessment of sanitation policies over the past fifty years is demanded, along with mapping of discharges and health risks. The ARS, Santé publique France, the Office of Water and scientific organizations must participate in this evaluation.

Multi-year work plan and funding

A multi-year work program must prioritize installations with the highest health and environmental risks, with clearly identified funding and deadlines. Low-income households must benefit from effective support for installation, rehabilitation and maintenance.

Public reporting and institutional action

Every year, the public must be informed of the number of stations and individual installations brought up to standard, the actual amounts spent and the health and environmental progress. The Martinique Assembly has the authority to create a single water and sanitation authority, but action must begin now to protect public health and the environment.