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Only 11% of Belize's population has access to sewerage services, according to a new report from the IDB.
While 81% of the population has access to sanitation facilities, these involve mainly pit latrines and septic tanks.
Sewerage collection and treatment is limited to just three cities, including the capital Belize City, Belmopan and San Pedro.
Expansion of the wastewater treatment and collection systems will not only improve public health and the environment but would also increase tourism given poor sanitation's "detrimental effect on tourism," according to the report.
Belize Water Services (BWS), the only licensed water and sanitation provider in the country, plans to start construction of a wastewater treatment plant on the Placencia Peninsula, a popular tourist destination, this year.
BWS is also planning on upgrading the Belmopan wastewater treatment plant this year, as well as expanding the wastewater collection network in the city.
However, despite these plans, BWS's main focus is on improving water services due to "the extremely high cost of sewerage services."
As a result, the IDB suggests that BWS and the government should consider developing a strategy for sewerage collection and treatment, similar to its 2010-15 business plan for water.