As Lydia Nalubyayi in Katoogo, Ggaba, Kampala wakes up in the morning, flies take off and land like helicopters. There is a lot of abandoned waste, including human excreta, for the flies to feast on. As the flies make repeated landings on the bug-infested filth, they bring germs to the residents.

In a crowded environment located on the shores of Lake Victoria, Nalubyayi and her neighbours have been fighting to get a decent life. This has been undermined over the years because they have too few toilets to provide adequate sanitation to the residents.

“It is hard to access a toilet,” she says, adding that she relies on a shared toilet with her neighbours, which creates many challenges, including the spread of infections.

“We suffer from many waterborne diseases, such as diarrhoea, because the toilets are always dirty.”

Not far away, Sarah Nakachwa says most of the residents lost their toilets to flooding.

“We had a toilet but it became flooded and now it is completely inaccessible,” she told New Vision.

Nalubyayi and Nakachwa are part of the 28 million Ugandans who either have shared toilets or do not have toilets, according to Herbert Nabaasa, the commissioner for health services, and environmental health in the Ministry of Health.

Kids Playing from a man-made structure in the middle of the water affected the people living on the shores of Lake Victoria in Gabba. (Photo by Jimmy Outa)

This, according to Nabaasa, is depriving many people of human dignity and that open defecation leads to the spread of diseases, which undermines economic growth.

“The cost implication is that more than 75% of the disease burden is preventable,” Nabaasa said, adding that most of the diseases that are preventable relate to poor access to water, sanitation and hygiene, which is referred to as the WASH sector.

Nabaasa says that up to 20% of the population of 43 million people practice open defecation, also referred to as ODF. This translates into 10 million people without toilets in Uganda.

According to Nabaasa, most people associate poor sanitation with rural areas, forgetting it is also a big urban problem.

“We have a big problem largely in Karamoja, where ODF is rampant, but we also have a problem in the slums or informal settlements in the cities, particularly Kampala,” said Nabaasa.

“There are people in the slums who still rely on flying toilets, where people ease themselves in plastic bags and throw away the waste.”

World Toilet Day

As the world on Saturday commemorated World Toilet Day under the theme, Making the Invisible Visible, people like Nalubyayi and Nakachwa, who do not stay in well-drained areas, come to mind.

The theme hopes to draw attention to how poor-quality toilets and inadequate sanitation systems negatively affect people’s health and also pollute the environment, particularly groundwater. The key message for advocacy is that everyone must have access to safe toilets, in line with SDG 6.2 (which focuses on sanitation).

“With only eight years left, the world needs to work four times faster to meet this target,” according to a statement from WaterAid.

Contaminated water

Away from poor access to toilets, poor disposal of faecal matter contributes to the contamination of underground water, according to Eng. David Luyimbazi, the deputy executive director of Kampala Capital City Authority said.

“Not all people in Kampala are connected to the sewer network,” said Luyimbazi, adding that about 10% of the population is connected to the sewer services provided by the National Water and Sewerage Corporation.

He also pointed out that people have resorted to constructing pit latrines and septic tanks, but these end up contaminating underground water.

“Most of the population in Kampala depend on underground water, but this is being contaminated by poorly constructed toilets.”

About 60% of the population in Kampala stays in slums or informal settlements, which rely on underground water as their source of drinking water, according to Luyimbazi.

The pit latrines and septic tanks should be lined with plastic materials so that the faecal matter is not released into the environment.

“We are planning to introduce container-based toilets,” Luyimbazi said.

Climate change

Katoogo is perched on the shores of Lake Victoria and is a place that is prone to flooding. This has worsened over the last three years as Lake Victoria spilled water onto the shores, making life difficult for nearby settlements.

As a result, some of the residents ended up being displaced into other parts of Ggaba, a lakeside town in Kampala. However, the floods have receded and some of the people are returning to Katoogo.

Callist Tindimugaya, a commissioner in the water ministry, explained that the water in Lake Victoria spilled into the protection zone, causing flooding.

He said this was caused by climate change and accelerated by excessive destruction of the environment — deforestation, and wetlands, which act as breaks for water.

At Ggaba landing site, Gamweru Walusimbi, a local leader, said flooding in Kampala led to the disruption of economic activities and the destruction of property, including toilets.

He said Ggaba has a high water table and that as a result, the new toilets that are being constructed are raised and they are built from the ground.

PWD disadvantaged

Viola Nalule, a resident of Ggaba landing site, said public facilities in the area do not favor People with Disabilities (PWD).

“There are no special facilities for PWDs,” Nalule said.

She added, “It is going to be difficult to move up the new toilet facility put in place at Ggaba landing site.”

What do others say?

Herbert Nabaasa, Commissioner-Public Health in the Ministry of Health  

We need to create awareness about the benefits of toilets and proper sanitation. In addition, districts should enforce the bylaws so that we can have bigger toilets and sanitation across the country.

Martin Watsisi, Regional WASH advisor at IRC International Water and Sanitation Centre 

While access to water is important, the promotion of sanitation has been down on the list of Government priorities, according to Watsisi. We have cases where Government allocates 800m for water in the districts and only 14 million for the promotion of sanitation and hygiene. Sanitation has been left in the hands of the private sector. The government needs to address public places like markets and taxi parks.

WaterAid

"At WaterAid, we believe that everyone everywhere has the right to a decent toilet. However, we recognize that far too many people, in our most vulnerable communities, can’t go to the toilet when they need to. "Even when toilets are available, they are often unsuitable for everyone, especially women, girls, older people, and people living with disabilities, hence putting their lives at risk of deadly diseases,” said Jane Sembuche, country director at Water Aid Uganda.
 
“In Uganda, we are committed to continuing to ensure that everyone, everywhere, has a decent toilet by 2030, but urgent progress is needed if we are to reach this goal." "That's why we are working with the government and all our partners to double and concert our current efforts, especially in institutions such as schools and healthcare facilities, to realize this aspiration."