November 19th, the UN cerebrates World Toilet Day; Toilet coverage In alarming situation

It’s a worldwide crisis. As 4.5 billion people live without a household toilet that safely disposes off their waste and about 2.4 billion people without access to basic sanitation services, the UN General Assembly called the World Toilet Day to be on every November 19th – worldwide! World Toilet Day is a call for action and an avenue for people to be reminded of their duties: to fight for adequate sanitation and hygiene competency!

Sustainable Development Goal (SDG) number 6, Clean Water & Sanitation, demands an achievement almost impossible to catch: Everyone shall have access to safe drinking water and adequate and equitable sanitation and hygiene by 2030.

Sanitation is essential to erase poverty. The lack of basic sanitation has severe negative impacts on food security, livelihood and educational choices, health, hunger and malnutrition, especially to children and women. The most vulnerable groups of society are more likely to get affected by infections caused by a lack of sanitation or missing awareness about the need for hand washing. Diseases like diarrhea can easily spread under conditions of no proper hygiene. Thus, on a global sphere, millions of people practice open defecation in their daily lives.

Besides the risk of being attacked by animals or other threats, it comes along with a lack of privacy and dignity when being exposed to the public. Additionally, poor sanitation infrastructure may cause environmental pollution if both soil and water get affected by bacteria. Consequently this pollution may affect people’s health – a vicious circle.

NO PRIVACY: Most toilets in oil rich Hoima district lack shelter. The toilet coverage is still low in the world and thus partly responsible for escalating hygiene related sicknesses

To achieve this ambitioned SDG, the participation of local government in improving water and sanitation management shall be supported and strengthened. Therefore, the Community Green Radio investigated on the current status quo of sanitation and hygiene in Hoima District. What are the local realities and challenges? And what are equitable steps to solve these problems?

The Acting Hoima District Health Officer, Dr. Frederic Byenuume estimates latrine coverage in the district to be around 65%. According to the Public Health Act, acceptable latrines fulfill the standards of at least 15 feet deep basin and appropriate shelters to provide privacy. While the coverage of safe drinking water is higher than the latrine coverage, in terms of hand washing the District is far beyond this coverage.

The lack of hand washing after defecating may transmit diseases within households and communities. Thus, he noticed recent cases of typhoid and cholera related to a lack of hygiene.
The sanitation and hygiene crisis comes along with a gender issue. Due to a privacy deficiency at home, women are exposed to open defecation when they fetch firewood or water. Open defecation close to water sources, however, may contaminate these. Moreover, he’s stated that some women don’t go to toilets during their pregnancy which may cause other hygiene related infections.

Dr.Byenuume’s views were confirmed by nursing officers at Hoima Regional Referral Hospital. Ms.Kategere Sylvia, Senior Nursing Officer at the Maternity Ward, records many women daily  from the rural areas that are not familiar with improved sanitation, such as water flow toilets. Some of them rather use stones or maize cobs instead of using toilet paper to clean their private parts arousing wounds in sensitive body parts. She added that sanitation deficiency in the rural villages causes menstrual infections to these women, especially after birth, forcing them to return to hospital. When staying in the ward, they may affect other patients and spread diseases. Nurses of the Maternity Ward noticed a return of 15 women monthly on average, with complaints on their private parts evoked by poor sanitation and hygiene.

The Nutrition Unit treats 50 cases of persistent illnesses resulting from poor hygiene monthly, says Senior Nursing Officer Ms. Haawa Birungi. The biggest numbers of these cases are children under the age of 5 years suffering from diarrhea and vomiting. She says when hands are contaminated with germs and not properly washed with soap; illnesses easily spill over to the whole family, especially to children.
According to the World Health Organization, there are 5 critical times of hand washing: after using a bathroom, after changing a diaper, before feeding a child, before eating and before preparing food. Much consideration must be taken for hygiene and a clean latrine before anything. However, most families don’t consider it as important and therefore practice open defecation.

Most infections in Hoima district occur along the shore of Lake Albert, says Lanyero Jenifer, Senior Nursing Officer at the Medical Ward. She says open defecation in the communities leads to liver problems, affects the stomachs and some patients even vomit blood, before they come to hospital. Ms Lanyero complained that some people save the toilet for their visitors, not taking care of their own health!

A visit to the villages in Hoima Municipality has drawn another image: As some people such as Nyanjura Kellen of Nyawairongo village in Busiinsi Division are aware of their lack of sanitation and hygiene, their economic situation doesn’t allow them to improve their current situation. That’s why poverty comes along with poor hygiene and bad sanitation. It’s the most vulnerable group that is exposed to germs, infections and even attacks. Bore holes without any coverage attracting flies and other insects can be witnessed in some areas, especially in the rural parts of the country. But what can be done to solve this crisis?

Taking these experiences into account, Community Green Radio’s investigation has shown evidence that the global sanitation and hygiene crisis also affects Hoima District, however, characterized by its specific challenges. It’s an alarming situation: The number of affected people is massive.

The impacts on health, environment, education, work, livelihoods, etc. are enormous. Nevertheless, solutions seem to be so basic. Building latrines doesn’t require improved technology. Moreover, when it comes to hygiene, washing hands can be located on a very basic level. Various steps need to be considered. First of all, sanitation is a human right. Everyone is entitled to have access to basic sanitation.
The poorest people need support from local government structures. In order to achieve SDG #6, adequate and equitable sanitation for everyone until 2030, much effort must be undertaken. Every household should have its own latrine according to WHO standards.

Additionally, hygienic competence is needed. People should be aware of the impacts of poor levels of hygiene. Hygiene affects sanitation, preparing food, eating, etc. However, hygiene is a very private issue sometimes hard to address. Consequently, tackling the sanitation crisis becomes a cultural issue. Let’s start talking about this very basic human need that affects us all in our daily lives.

By Robert Katemburura & Steffen Bittner