One billion still defecate in the open

By Elvis Basudde

The toilet is a small, but fundamental part of everyday life. But do we know how many have access to this fundamental
facility?

According to research, more than 80% of sewage in developing countries is discharged untreated into water bodies. All  because the culprits do not have access or do not appreciate the importance of using a toilet. Of the world’s seven billion
people, 2.5 billion do not have improved sanitation. One billion still defecate in the open.

Women and girls risk rape and abuse because they have no toilet that offers privacy.  Created in 2001, the World Toilet Day is observed annually on November 19  as an international day. It is recognised by the UN as a day for raising awareness on
the importance of sanitation.

The day also presents an opportunity to strengthen the advocacy for a Sustainable Development Goal, dedicated to water and sanitation. This is the second time Uganda is commemorating the World Toilet Day.

“Equality and dignity” is the global theme for this year’s celebration. The campaign aims at actions to end open defecation and put the spotlight on how to access to improved sanitation leads to a reduction in assault and violence on women and girls.

Defecating in the open infringes on human safety and dignity. Women and girls risk rape and abuse as they wait until night falls because they lack toilets. Toilets remain inadequate for people with special needs, the elderly, women and girls requiring facilities to manage menstrual hygiene.

Grace Alupo, the head of policy, research and campaign at WaterAid-Uganda says the theme for the celebrations in Uganda is “Everyone has a right to a clean and healthy environment,” as enshrined in the Constitution.

The celebrations will be held in Amuria district as it is rated among the best performing districts on sanitation this year,  according to the Ministry of Water and Environment’s sector performance report.

According to the report, the level of rural sanitation is at 74.6%, while urban sanitation is at 84%. The percentage of households with handwashing containers after toilet use is 32.8%. The percentage of schools with the handwashing
facilities stands at 38%. The country aims at 100% coverage of households with hand-washing facilities by 2015, a target that may not be achieved.

The sewerage service as of June was at 6.4%, according to the water ministry. The major reason for the low sewer connection rate is the high investment costs involved. The sanitation level of most of the districts in Karamoja is below 20%, a figure way below the national coverage of 74.6%.

Government puts the pupil:latrine stance ratio in primary schools at 70:1 against the national target of 50:1.

Alupo says the performance of districts on sanitation is based on data received both from the district water office, and the district health department. It is the fifth year since the ranking of districts basing on sanitation started, and this year, the best district is Amuria.

What is being done to improve the situation?

According to Alupo, a national sanitation working group was established, with a memorandum of understanding among the ministries of health, education and water. All the three ministries are expected to contribute to sanitation.

Many studies have been done on sanitation, by agencies like the World Bank’s Water and Sanitation Programme. One of the
studies was on faecal sludge management and sanitation in schools.

The water ministry identified and clustered small towns in the country to guide sector investment in cost-effective, shared, faecal sludge disposal facilities and improved engagement of the private sector and local authorities in service delivery.

The Uganda Sanitation Fund has been providing funds for rural sanitation and hygiene education for the past three years. The Fund now provides money to 30 districts in the country.

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(L) An ecosan toilets built in Kamwokya, Kampala, under the ecological sanitation programme. (R) Workers constructing toilets in Kiryandongo district. The level of rural sanitation is at
74.6%. In urban areas, it is 84%

“The project aims at turning 9,327 villages into open-free defecation communities after five years of implementation. So far, 3,980 villages have been covered and half of these declared open free defecation communities,” explains Alupo.

Under the district sanitation grant and through UNICEF, home improvement campaigns and the Community Led Total Sanitation programmes were implemented. A total of 1,736 villages were covered and 412 villages reported to be open free defecation.

Alupo says although the household latrine coverage over the last three years did not show much improvement, in 2013, 74.6% of the people in rural areas are reported to have access to sanitation, from 71% the previous financial year.

The improvement in sanitation has put Uganda back on track to meet the national target of 77% access to rural sanitation by 2015. The improvement is largely attributed to an increase in financing, improved support supervision, improved use of the
implementation guidelines, as well as an increase in the follow up by extension workers at districts and sub-counties.

However, about 56 districts will not be able to achieve the 77% coverage by next year. The districts include those found in Karamoja, where there has been considerable progress in the last five years, with an overall increase of 11%, compared
to 6% in the rest of the country.

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Former water minister Jennifer Namuyangu washing her hands in a tippy tap in Lira. The tippy tap is commonly used in villages after visiting the latrine

By the end of June, the rural access to hand-washing facilities at toilets was reported to be 32.7%, an increase of 3.7% from the last financial year.

Districts report that 38% of primary schools have access to hand-washing facilities, but the information does not take into consideration the school population, which may affect the rate of hand-washing by the pupils, if the facilities are used by many of them.

The access to hand-washing facilities in urban areas, excluding Kampala, is estimated at 35%, Alupo explains. On Friday last week, the Office of the Prime Minister organised a national dialogue on sanitation and to prepare for the World Toilet Day
celebrations today. Prime Minister Ruhakana Rugunda was the chief guest.

The parliamentary Water, Sanitation and Hygiene Forum was founded in 2012 after a research by WaterAid recommended the
need for a specific forum on sanitation and water. The focus of Parliament is to prioritise aspects of water, sanitation and hygiene in Government.

We need more toilets in public places, says Amongin

The World Toilet Day was declared on November 19, 2001 and is celebrated with events hosted by various water and sanitation  advocates. The World Toilet Organisation created the day to raise global awareness of the struggle 2.6 billion people  face every day without access to proper sanitation. Uganda is one of the countries that joins the rest of the world to mark this day. Jeff Andrew Lule talked to Hon. Jacqueline Amongin, the chairperson of the parliamentary Forum on Water and Sanitation,  about the state of toilet coverage in Uganda.

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Amongin says the state of toilet coverage is actually worse than statistics show

What is the state of toilet coverage in Uganda?

According to the World Bank report of 2013, under the Water and Sanitation programme, 13.8 million Ugandans use unsanitary or shared latrines, while 3.2 million people have no latrines and defecate in the open. This poses a threat to people’s health.
A study by the Uganda Bureau of Statistics shows a ratio of 70 pupils per stance (toilet) in schools, which is not true. When we visited schools, we realised toilets were fewer, and all pupils shared the same toilets. Like in Kawempe Muslim Primary
School in Kampala, we found 800 pupils sharing only two toilets. Many toilets in schools are in appalling state and need to be rehabilitated.

How do you compare the situation to the previous years?

Government has tried to address sanitation problems in the country. But there is still need to construct more toilets along high ways, to stop poor disposal. We need more toilets in public places, like markets.

The Government has also built toilets in different areas, but they are not utilised due to poor management. I think people need to be sensitised on how to use and manage the toilets.

What are the most hit areas?
Slums like Katanga, Kamwokya and markets. These areas are congested and people use ‘flying toilets’ (defecate in polythene bags). Such a practice risks people’s lives and we need to do something about it. Even in many rural areas, people still use bushes.

What could be the problem and who is to blame?

Some leaders have not played their role to sensitise people. Many blame the Government, but we are all part of the Government. We should join hands to solve the problem.

What are the likely effects of the problem and how has this cost the Government?
We lose many people to preventable diseases due to poor hygiene and sanitation. About 23,000 Ugandans, including 19,700 children below five years, die of diarrhoea each year and 90% of the deaths is attributed to poor water sanitation and hygiene.

About $1.7m is lost to funerals, while $21m is lost every year to diarrhoea and cholera. We have other costs arising out of poor sanitation and epidemic outbreak costs. All this money can be used to construct toilets in schools and public places.

What has the Government done to improve sanitation and hygiene challenges?
They have provided safe water and many projects are still ongoing. However, the main challenge is maintenance. In some areas, you find rusty boreholes. This is dangerous and we are proposing plastic pipes. Secondly, we want the Government
to provide water points at schools, spare sanitary towels and dresses, and changing rooms for girls to help them manage hygiene during menstruation periods.

On top of sensitising the local communities on hygiene, we also want local leaders to put bylaws to punish all those without toilets in villages. They should be treated like outcasts. They should also introduce an affordable fee on public toilets to buy
toilet paper and for maintenance.

ADVERTISER SUPPLEMENT

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MARKING WORLD TOILET DAY – SAVE UGANDA’S CHILDREN FROM DIARRHOEAL DISEASES

An estimated 40,000 children in Uganda die annually due to diarrhoeal diseases and pneumonia – estimated 110 children die
each day. An open defecation free environment and proper hand-washing alone can help halve these deaths (MoH).

See details

STATEMENT IN RELATION TO THE STATE OF WATER AND SANITATION IN UGANDA TOWARDS WORLD TOILET DAY – (NOVEMBER 19) MOVED BY HON. AMONGIN JACQUELINE, CHAIRPERSON UGANDA PARLIAMENTARY
FORUM ON WATER, SANITATION AND HYGIENE (UPF-WASH) (Under Rule 45 of the Rules of Procedure of Parliament)

See statement here