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Under the International Waters Project (IWP) in Tuvalu, a pilot project was established to address "waste" with the aim of reducing the contamination of groundwater and coastal water by human and animal waste. Community-based activities included "low-tech" solutions to addressing environmental degradation while national level activities involved activities with a more strategic institutional focus. A Communications and Sanitation Training Programme was designed to investigate the current understanding of poor sanitation in Tuvalu, raise awareness of its cost to public and environmental health, and promote possible solutions.

Sewage is used water, or the "waste water" that comes from the toilet, or from household cleaning activities such as dishwashing, clothes washing, cleaning the house, or cleaning a boat or motorbike. Waste water can be harmful to the environment and to your health. It is harmful to the environment because it can contain high levels of nutrients (from faeces, urine, detergents) and other chemicals. It is harmful to your health because it can contain disease-causing organisms called pathogens.