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Open Defecation in Sub-Saharan Africa

Open Defecation in Sub-Saharan AfricaThe United Nations’ Sustainable Development Goal 6 calls for the elimination of open defecation practices by 2030, and sub-Saharan Africa remains the greatest challenge in achieving this objective. With this goal in mind, concerted global efforts are being made to ensure success.

Open Defecation

According to the U.N., open defecation is the practice of excreting in an open space such as a field, river, or street, rather than using a toilet. The U.N. also reports that in 2017, despite open defecation rates nearly halving since the turn of the century, around 670 million people still practiced open defecation.

Two main issues surround the practice. Firstly, open defecation leads to the spread of diarrheal diseases, through the contamination of drinking water and crops. Diarrheal diseases are the leading global cause of child deaths, leading to around 800 children under the age of 5 dying each day.

Secondly, the practice leads to an increased risk of sexual violence against women. In 2016, UNICEF estimated that 50% of rapes that took place in India happened whilst women were defecating in the open.

Successes in India

India has been the focus of efforts to end open defecation for many years, due to the proportion of the large population that were practicing it. Between 2000 and 2017, the number of people practicing open defecation in India fell by 55%. While many question the government’s claim that India became “open-defecation-free” in 2019, there have undoubtedly been huge successes in reducing the rates of this practice across the country.

Global support and government funding under Prime Minister Narendra Modi led to a rapid and widespread rollout of toilets across India. Modi’s “Clean India” campaign began in 2014 and led to the building of 110 million toilets; one initiative led by LIXIL built 47,000 toilets each day.

Despite the successful roll-out of toilets across India, open defecation remains a common practice. Many researchers put this down to cultural barriers; rather than being the result of a lack of toilet, open defecation is most commonly an “ingrained cultural norm,” according to the U.N. Consequently, any long-term solution requires a focus on community perception and behavior alongside the construction and maintenance of proper toilets and sanitation services.

A 2020 study highlighted the successes of a community-based information campaign in Uttar Pradesh, India, aimed at rebranding the use of toilets and instilling new beliefs around the importance of sanitation. The social beliefs that are behind the persistent open defecation in India are twofold: beliefs that no one in the community uses toilets, and beliefs about rituals of purity and cleanliness. By directly tackling these social beliefs, the information campaign saw an increase of 11% in toilet use in villages across Uttar Pradesh.

Applying These Lessons in Africa

Open defecation in sub-Saharan Africa has become an increasingly significant focus in global health efforts. Based on the most recent data available, nine of the 10 countries with the highest percentage of the population practicing open defecation were in sub-Saharan Africa.

Furthermore, between 2015 and 2018, most of the countries with the highest proportion of the population exposed to community open defecation and its impacts were found in Africa, reaching a high of around 90% of the population in Benin and Ethiopia.

As in India, many of the reasons for open defecation in sub-Saharan African nations surround socio-cultural beliefs and values. Therefore, the successes and limitations of the approach taken in India have the potential to inform more effective practices across this region.

In Niger, 68% of the population was practicing open defecating as of 2020, according to the World Bank and only 13% of the population had access to basic sanitation services such as a toilet. Therefore a rapid and widespread roll-out of these sanitation services, as seen in India, has the potential to drastically change open defecation rates in Niger.

Practical and Cultural Approach

There are some examples of practical and cultural approaches to reducing open defecation rates. Between 2017 and 2018, UNICEF partnered with the Government of Niger to develop a plan to end open defecation by 2030. In 2020, the Bagaroua commune became the first Open-Defecation-Free community in Niger. The community chief put the success down to the roll-out of toilets in the region, which saw access to latrines increase from 10.3% to 100%, as well as the “sensitization” program which promoted behavior change. As a result of the work done by UNICEF and the Government of Niger, many parents in the Bagaroua commune reported that they realized the need to change their behaviors to keep their children safe.

Armed with lessons from India and other countries paired with a practical roll-out of sanitation facilities with a culturally-sensitive education initiative, the international community could more effectively work towards ending open defecation in sub-Saharan Africa.
– Polly Walton
Photo: Flickr

 

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10 Facts About Sanitation in Malawi

Sanitation in MalawiMalawi is an impoverished, landlocked country in southeastern Africa. As is common among impoverished nations, Malawi critically struggles with health and sanitation. Here are the top 10 facts about sanitation in Malawi.

Top 10 Facts About Sanitation in Malawi

  1. Menstrual hygiene – In Malawi, there are imbedded cultural beliefs surrounding menstruation that lead to communal ignorance. This stigma surrounding menstruation extends to schools, where girls similarly do not receive education about menstruation. Furthermore, most school bathrooms provide little to no privacy. This lack of privacy, combined with the societal shame of menstruation, results in girls leaving school once they get their period.
  2. Hygiene in schools – For children without access to clean water, toilets or soap at home, school can be their only hope of sanitation. Unfortunately, hygiene in schools often falls short in Malawi. As of 2018, only 4.2% of Malawian schools had handwashing facilities with soap and 9% did not have a secured water source.
  3. Education about hygiene and sanitation – Schools are a key tool for educating youth on basic hygiene and sanitation, especially due to the fact that children are effective agents of behavior change. They capable of sharing lessons they learn at school with their local community. However, similar to their lack of sanitation infrastructure, schools also lack education surrounding sanitation in Malawi. Even if schools did offer education surrounding hygiene and sanitation, high rates of enrollment would be required to create a large scale change in behavior. In many rural communities, girls are tasked with traveling long distances to collect water. This responsibility combined with the obstacle of menstruation reduces female enrollment in school.
  4. Toilets – As of 2015, 9.6 million Malawians – almost half of the population – did not have access to an adequate toilet. There are two types of toilets in Malawi. The first is the Western-style with a toilet bowl and a seat; the second is a hole in the ground. The Western-style is common in urban towns and cities while the hole in the ground is common in rural areas.
  5. Open defecation – In 2008, Malawi adopted the Community Lead Total Sanitation and Hygiene program (CLTS) in an effort to make the country Open Defecation Free (OPF). Malawi has made great strides, but 6% of rural communities continue to openly defecate. Open defecation results from inadequate health infrastructure such as toilets and is a key health concern in Malawi. Open defecation is linked to sanitation-related diseases, high child mortality and the spread of cholera.
  6. Access to water – As of 2015, only 67% of households in Malawi had access to basic drinking water. Similarly, 5.6 million do not have access to a safe water source. In fact, pproximately 30% of water points in rural areas were non-functional at any given time. Water is deeply intertwined with sanitation. Without access to clean water people catch water-borne diseases, are unable to stay clean through bathing and risk their safety by traveling long distances to receive water.
  7. Access to local sanitation facilities – As of 2015, only 42% of Malawian rural households had access to basic sanitation services. Consequently, in 2018 there were 9.9 million people in Malawi who did not use basic sanitation. Combined with poor transportation infrastructure, this lack of local sanitation facilities places strain on rural communities. Communities that do not have secure access to water, predominantly rural communities, are reliant on local sanitation facilities to stay clean and healthy. Thus, without such facilities, the risks of experiences the consequences of poor sanitation increase dramatically.
  8. Role of drought – In the past 36 years, Malawi has experienced eight major droughts. Droughts directly cause a reduction in water availability and thus, indirectly impact sanitation. The most recent drought in Malawi occurred in 2016 and disrupted household economic activities by increasing the time needed to search for water. It also increased the degradation of water catchment areas and increased the risk of water-washing diseases due to a prioritization of water for drinking rather than personal hygiene. Drought places another obstacle in the way of achieving universal sanitation in Malawi.
  9. Higher risk of diseases – Poor sanitation and unhygienic practice result in approximately 3,000 under-five child deaths per year in Malawi. Diarrhea is often a tragic consequence of poor sanitation with 11.4% of infant and child mortality resulting from diarrhea. Similarly, even if diarrhea does not result in death, frequent episodes can yield a negative effect on child development, stunting and acute respiratory infections. Furthermore, poor sanitation not only leads to diarrhea but also waterborne illnesses such as cholera. Thus high rates of communicable diseases are intimately tied to poor sanitation in Malawi.
  10. Improvements to WASH services – USAID is an active participant in increasing WASH services in Malawi and has made great progress. In 2015 alone USAID had constructed 60 shallow wells and three boreholes. It built 360,080 toilets with handwashing facilities as well as installed 2600 chlorine dispensers in 25 villages. This progress provides hope for the achievement of universal sanitation in Malawi.

Malawi is an impoverished African nation currently suffering from inadequate sanitation. This lack of sanitation in Malawi not only impacts health but household income and child attainment of education. While progress has been made through organizations such as USAID, more still needs to be done. Please consider visiting the Borgen Project website on information on how to call or email your representatives to put international aid as a priority on the U.S. agenda.

– Lily Jones
Photo: Flickr

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10 Facts About Sanitation in Africa

Sanitation In Africa
Sub-Saharan Africa has 52 countries, all of which have large swaths of their population’s using toilets that encourage disease, or worse, relying on open defecation as the only way to dispose of waste. With 1.094 billion people on the continent, there is plenty of room for improvement. Here are 10 facts about sanitation in Africa.

10 Facts About Sanitation in Africa

  1. Socioeconomic Status: sub-Saharan Africa’s sanitation issues correlate with an individual’s socioeconomic status. Essentially, the poorest individuals are 18 times more likely to practice open defecation, which amounted to over 220 million people in 2015.
  2. Improved Sanitation in Uganda: In Uganda, 45 percent of the rural population and 27 percent of the urban population need to walk over 1 km to access an improved sanitation facility. Improved sanitation facilities include “flush or pour-flush to a piped sewer system, septic tank, pit latrine; ventilated improved pit (VIP) latrine, pit latrine with slab, [or] composting toilet.”
  3. The Millenium Development Goal (MDG) for Sanitation: Western Africa, Eastern Africa, Southern Africa and Central Africa were not on track to meet the Millennium Development Goal for sanitation in 2008. In fact, out of 52 countries in Sub-Saharan Africa, only one allocated 0.5 percent of its GDP to sanitation measures. Budgets have 0.5 percent as the minimum for sanitation. Goal 7 of the Millennium Development Goals was to ensure environmental sustainability, and that included climate change aspects in conjunction with improved drinking water access and improved sanitation access. When looking at the sustainable development goals, out of the 52 counties, the vast majority are reaching stagnation. Reaching goal 6, which is for clean water and sanitation, will require internal mobilization and increased funding from external sources to meet the 2030 deadline.
  4. Return on Sanitation: When governments allocate funding for improved sanitation options, it tends to be lower than necessary because they do not consider it an economic venture that will have a monetary return. This is especially the case for developing countries because they often want as much money as possible for investments to receive large returns and get the most value from their dollars. The World Health Organization estimates that the return on sanitation spending is 550 percent or in other words, $5.50 for every $1 that a government invests in improved sanitation methods in Africa.
  5. The Loowatt Toilet: Loowatt provides a toilet made of horse dung that is perfect for use in developing countries. It is a waterless system, which is fantastic for drought-stricken countries and regions. Additionally, it turns human waste into energy biofuel at a reliable rate if people use it regularly. The best part is that it has a low cost of 12 Euros as a deposit and a 3 Euro monthly service fee. In the country of Madagascar, it went beyond proof of concept, and the company was maintaining over 100 toilets that serviced over 800 people in 2017. Since then, over 100,000 customers in both the U.K. and Madagascar have used Loowatt toilets.
  6. South Africa: South Africa determined that access to water is a right in 2002 and it set the supply to 25 l/c/d or 6 kiloliters per connection a month. However, South Africa has just recently made the transition from supply to sanitation access. For both rural and urban sanitation, over 50 percent of the annual and per capita investment requirements are unavailable due to a lack of ability to provide the full $1.218 billion the country requires.
  7. Ghana and Open Defecation: No district in Ghana has a 0 percent open defecation status, and three out of 10 rural households practiced open defecation. Over 81 percent of the Ghanaian population lack access to improved sanitation. Organizations are trying to bridge the gap between the people who cannot pay upfront to build the improved sanitation facilities by providing WaterCredit. WaterCredit is essentially a way for the poor to get water and sanitation loans. Currently, Water.org has facilitated $2.4 million through its partners in microloans for water and sanitation purposes in Ghana.
  8. Peepoo: With the creation of the Peepoo, those with communicable toilets can access safe sanitation and prevent others from getting the disease they may be infected with. Peepoo is a biodegradable bag that sanitizes human feces and allows it to become fertilizer in about a month. It attacks the problem of sanitization at the source by giving an alternative to open defecation that does not require a sizable investment to build a toilet. Peepoo sales have mainly occurred in Kenya, where the company continues to do research and build the foundation for easier use. A study that Peepoo conducted with a grant examined 37 schools with about 6,500 students to determine the effectiveness of Peepoo sanitation and deworming, both independently and combined. The results in 2016 included improved attendance and overall improved health due to the reduction in diarrheal diseases in the school children.
  9. Open Defecation in Urban Areas: The number of those practicing open defecation is increasing in urban areas due to the rapid size increase of the overall area, without proper permits for building or a focus on providing latrines and washrooms. Additionally, including cost as a factor, urban slums are sometimes cheap and an affordable option for the poorest individuals. In particular, open defecation in the Kampala Slum is at about 28 percent while estimates determine that 1 percent of Uganda’s urban population openly defecates.
  10. The Leave No One Behind Pledge: The Sustainable Development Goals emerged to replace the Millennium Development Goals, and goal 6 of providing clean water and sanitation aims to “Ensure availability and sustainable management of water and sanitation for all.” These goals also focus on helping those furthest behind first through the Leave No One Behind pledge. The pledge itself is a way to ensure that those facing the worst of poverty end up at the forefront of progress by confronting the inequalities as a method of reducing the number of individuals living in extreme poverty. This pledge is an overarching goal for all of the sustainable development goals and encompasses the fact that those worst off should be a primary focus in order to achieve the goal at hand. Even with this pledge, it is likely that about 60 percent of the countries will not reach the target of full implementation by 2030. However, Uganda is a leading example of the potential countries that may achieve goal 6, thanks to its national development plan which includes policy in line with the sustainable development goals but with adaptations to reflect cultural and national contexts.

Sanitation in Africa, specifically Sub-Saharan Africa, is still vastly below the goals, although the continent is making progress. With the continuing improvements and government’s investments into sanitation, African nations could see increased levels of productivity and return on their investments. Northern Africa had met the Millennium Development Goals and continues to increase its standard of sanitation. As the world progresses towards 2030, it can expect to see dramatic sanitation improvements after the completion of thorough research regarding the investments and implementation of sanitation techniques.

– Cassiday Moriarity
Photo: Pixabay

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10 Facts About Sanitation in Cambodia

sanitation in Cambodia
Despite experiencing robust economic growth in recent years, GDP per capita in Cambodia remains low. While urban Cambodians are now able to enjoy increased sanitation services and access to clean water, the majority of the population resides in rural areas where the living conditions are sub-standard. Below are the top 10 facts about sanitation in Cambodia.

10 Facts About Sanitation in Cambodia

  1. Access to Clean Water and Sanitation: Approximately 50 percent of the population has access to improved sanitation and basic water supply, but only a quarter has safely managed water. More than 2 million people, or about 13 percent of the population, are still living without clean water and 6 million do not have access to safe sanitation.
  2. Increased Access to Improved Sanitation: The total number of people with access to improved facilities increased from 3 percent in 1990 to 42 percent in 2015. Cambodia has eradicated open defecation in urban areas and 88 percent of urban Cambodians have access to improved facilities. The progress is even remarkable among the poorest urban households with 82 percent now having access to improved sanitation, up from 0 percent in 1990.
  3. Open Defecation: Cambodia has the highest rate of open defecation in the region with 80 percent of the poorest rural Cambodians defecating in the open. This unsafe practice contaminates the land and water sources, exposing the population to dangerous waterborne infectious diseases and causing preventable deaths. Cambodia is working towards its national target of eliminating open defecation by 2025.
  4. Disparities Between Urban and Rural Areas: Forty percent of Cambodians in rural areas do not have access to hand-washing facilities compared to only 12 percent of the urban population. Almost 90 percent of the urban population has access to improved latrines while only 40 percent of the people living in rural areas do.
  5. Economic Costs: Lack of sanitation costs Cambodia up to $448 million annually, which is equivalent to 7.2 percent of the nation’s GDP. Health-related losses are some of the largest contributors to this economic impact, which account for 42 percent of the impact, or $187 million. Costs of accessing cleaner water, welfare and time losses and tourism loss due to poor sanitation also contribute to the high economic impact.
  6. Asian Development Bank (ADB): To support financing Cambodia’s goal of providing universal access to improved water supply and sanitation services by 2025, the ADB has approved $49 million in funding. Since 2005, more than 1 million people in Tonle Sap Lake have received benefits from ADB-supported water supply and sanitation services projects. The new project will benefit more than 400,000 people in at least 400 Cambodian villages.
  7. Plan International Cambodia: Since 2006, the program by Plan International has helped to promote the adoption of clean water consumption, hygiene and sanitation practice in hundreds of Cambodian villages. Using the community-led total sanitation approach, the program has helped 750 villages achieve the open defecation free status, as well as construct and install 130 wells, 65 water purifying systems and 700 sanitation facilities at schools.
  8. Latrine Access: Cambodia is making steady progress in increasing latrine access in the population, doubling the coverage rate in rural households from 23 to 46 percent in five years. Production costs have plunged, making latrines accessible and affordable to an increasing proportion of the population. The director of the Department of Rural Health Care estimates that 80 percent of Cambodians can now afford latrines.
  9. Cambodia Rural Sanitation: iDE, or previously International Development Enterprises, has announced a $10 million Development Impact Bond (DIB) to support Cambodia’s sanitation initiatives in partnership with USAID and the Stone Family Foundation. It is the world’s first DIB developed for the WASH sector, aiming to eradicate open defecation in 1,600 villages in six provinces by 2023. The impact bond will support iDE’s Sanitation Marketing Scale-up Program, which delivers affordable latrines to 10s of thousands of households annually and has successfully increased sanitation coverage from 29 percent in 2009 to 67 percent in 2018.
  10. Sanitation Marketing: Traditional programs focusing on education may be successful in raising awareness, but do not always translate to purchases of hygienic toilets. Sanitation Marketing is a market-based approach that aims to increase both the capacity to supply and the demand for sanitation by making owning a toilet more appealing and desirable for families. iDE and WaterSHED implemented this new approach and focused on the rural Cambodian areas, and both have been successful in enabling the sale of more than 260,000 toilets and increasing improved sanitation coverage in Cambodia’s rural communities considerably.

These 10 facts about sanitation in Cambodia give a brief overview of the challenges and progress the country is making regarding the WASH sector. Cambodia is making improving the quality of water and sanitation a priority, which not only ensures the basic rights of people and protects human dignity but also indirectly and directly benefits Cambodia’s socio-economic development. Despite facing many challenges, with support from different international and local NGOs, the government of Cambodia has committed itself to the achievement of its goal of providing universal access to clean water and sanitation services by 2025.

– Minh-Ha La
Photo: Flickr