By Chioma Obinna
Good sanitation, together with good hygiene and safe water, are fundamental to good health and socio-economic development. This aligns with a school of thought which believes that environmental sanitation and hygiene are human rights. The United Nations Sustainable Development Goals, SDGs, state, explicitly, in Goals 3, 6, 8, and 11 the essence of an environment that is safe for all. According to Goal 3, we must “ensure healthy lives and promote the well-being for all at all ages”; Goal 6, we must “ensure availability and sustainable management of water and sanitation for all”, Goal 8, we must “ensure availability and sustainable management of water and sanitation for all”, and Goal 11, we must “make cities, and human settlements inclusive, safe, resilient and sustainable.”
But how real are these statements today in Nigeria? This is a one-million dollar question begging for an answer? For instance, Sunday Vanguard visited the rail line along Lagos–Badagry Expressway under construction and reports.
Walking along the yet to be completed rail line at the Mile 2 area of Lagos, one could vividly see the myriad health and widespread sanitation problems and other environmental challenges. From the Orile end of the rail line to the Mile 2 side of it, the Lagos – Badagry Expressway is not only a den of hoodlums and the destitute but has also become some kind of toilet facilities for all manners of persons including passers-by. While the terminals serve as home for street beggars, other activities such as illegal drug trading and all forms of abuses take place along the rail. One prominent challenge which could become a hurdle in infection control in the area remains indiscriminate dump of refuse and open defecation.
As you read this article, Nigeria, according to the 2017 data from UNICEF, is among the countries practicing open defecation in the world with over 46 million engaging in the habit. A visit to the area by Sunday Vanguard revealed a hopeless situation and calls for immediate attention. Further investigation by Sunday Vanguard revealed heaps of refuse oozing offensive smell.
Lagos State government had, in 2009, awarded the contract for the rail line, from Iddo terminus to Badagry, to China Civil Engineering and Construction Company, CCECC. The project was also for the expansion of the previous four-lane highway to 10 lanes.
Sadly, the government’s people-oriented project, designed to facilitate trade and commerce on the international highway, may be brewing an epidemic if nothing urgent is done to bring back the environment to a habitable condition. According to health watchers, although, over the last few years, the general health of Nigerians has improved and life expectancy has increased, Nigeria still faces lots of environmental and health risks, especially in Lagos and many other cities across the country.
A 2017 Multiple Indicator Cluster Survey, MICS, released by the National Bureau of Statistics, NBS, showed that many Nigerians are exposed to life-threatening environment due to poor sanitation and drinking water. The report indicated that Nigeria has a long way to go if she hoped to meet Goals 3, 6, 8 and 11 of the United Nations’ SDGs which target good health.
Some passers-by and traders, who spoke to Sunday Vanguard, described the situation in Mile 2 as a lingering eyesore. One of them, who simply identified himself as Mr. Emmanuel Uduak, said: “It is sad that our people no longer consider defecation in the open and the attendant environmental challenge as unwholesome and the environmental sanitation people are not doing their job. Are we supposed to have a place like this? This place will tell you what Nigeria has become”.
Uduak argued that the condition of the place should be a cause for worry to those constructing the rail since this could lead to the outbreak of diseases.
A woman selling herbal mixtures and local gin (Paraga) around the area blamed the indiscriminate disposal of faeces in Mile 2 on inadequate public toilet facilities.
According to her, there are “just a few mobile toilets around here and most of the operators are not friendly”.
She added, “There is one mobile toilet somewhere there but the elderly woman operating the toilet is terrible. Oftentimes you will almost defecate in your pants before you could convince her to collect the money you have. “
Others, who spoke to Sunday Vanguard, complained of high charges by the toilet operators. One of them, Mr Abdul, 32, told Sunday Vanguard that to pass urine costs N50 while to pass faeces costs N100 which, according to him, many people in the area cannot afford sometimes when you have to do it twice a day.
“How many of us who work and live here can afford the charges? So you can see why you have faeces everywhere here and the situation will continue unless government and the sanitation people do something urgently”.
Indeed, a toilet and bathroom built at a point adjacent to the Benin bus terminal in the Mile 2 area are visible for all to see but most travellers who are meant to pay N100 for faeces and N50 for urine do not use the place because of the charges.
Sunday Vanguard reached out to the Lagos State Ministry of Environment on our findings where the Special Adviser to the Governor on Environment, Mr. Babatunde Hunpe, blamed the situation on lapses in the monitoring of the environment in the state but said the administration had done much to address the issue.
“Governor Akinwumi Ambode has appointed SSA an Environmental Monitoring and another on Waste Policing. These people will complement our efforts in the area of monitoring and prevention of pollution in the state”, Hunpe said.
“We also have the Lagos State Environmental Sanitation Corps, LAGESC, former Kick Against Indiscipline, KAI. And their primary responsibility is to police the environment. They are empowered by the law. Anyone found violating the environmental law of the state would be prosecuted”.
On public toilets, he said: “Aside the public toilets the government is building, we are also partnering with the private sector to do same. We also want to appeal to corporate organizations and individuals to construct public toilet as their own Corporate Social Responsibility, CSR, in the state. The door of our ministry is open for such partnership.”
Meanwhile, critical health and environmental watchers believed that the situation in the area, if neglected for too long, could expose Lagosians to environmental and health risks. Citing the adage, ‘Cleanliness is next to godliness’, they called on government officials to regularly visit and evacuate the human and environmental wastes around the area.
X-raying the dangers of poor sanitation
According to experts, open defecation is a major cause of fatal diarrhoea. Statistics available showed that 315,000 children die every year through poor sanitation and unsafe water caused by diarrhoea while 4.5 billion people live without household toilets that safely dispose wastes. Also, the National Demographic Health Survey showed that up to 97,000 children die from diarrhoea each year. More depressing is the fact that this needless suffering is actually preventable.
Findings also showed that lack of sanitation leads to disease, as was first noted scientifically in 1842 in Chadwick’s seminal. Faeces are most dangerous to health. One gram of fresh faeces from an infected person can contain around 106 viral pathogens, 106–108 bacterial pathogens, 104 protozoan cysts or oocysts, and 10–104 helminth eggs. Diarrhoeal diseases are the most important of the faeco-oral diseases globally, causing around 1.6–2.5 million deaths annually, many of them among children under 5 in developing countries.
Systematic reviews suggested that improved sanitation can reduce rates of diarrhoeal diseases by 37 per cent.
It has also been found that poor sanitation could lead to Neglected Tropical Diseases such as schistosomiasis, which can result in chronic debilitation, haematuria, impaired growth, bladder and colorectal cancers and essential organ malfunction. It could also lead to acute respiratory infections and under-nutrition.
Poor sanitation, hygiene and water are responsible for about 50 per cent of the consequences of childhood and maternal underweight, primarily through the synergy between diarrhoeal diseases and under-nutrition whereby exposure to one increases vulnerability to the other.
According to UNICEF’s Head, Global Water, Sanitation and Hygiene (WASH) programmes, Sanjay Wijesekera, lack of sanitation is a reliable marker of how the people in a country are faring. “Although it is the poor who overwhelmingly do not have toilets, everyone suffers from the contaminating effects of open defecation; so everyone should have a sense of urgency about addressing this problem”, he said.
“The challenge of open defecation is one of both equity and dignity, and very often of safety, particularly for women and girls”.
An environmental health expert, Dr Oladapo Okareh, said Nigerians that are used to defecating in open places were to be given proper orientation. According to him, the practice could lead to outbreak of diseases like cholera and diarrhea. Okareh, a Senior Lecturer in the Department of Environmental Health Sciences (EHS), University of Ibadan, in a report, said: “Open defecation is the practice whereby people go out in fields, bushes, forests, open bodies of water or other open spaces rather than use the toilet to defecate or pass bodily waste. Open defecation constitutes a major public health problem due to rapid urbanisation, lack of public toilets and low level of awareness.
“Open defecation is a public menace because it could easily lead to outbreak of communicable diseases like cholera, typhoid, diarrhoea, intestinal infections, respiratory diseases and tuberculosis”.
He said it also causes air and water pollution when human faeces are washed away during the rainy season.
“Water supplies can become contaminated with such faecal matters; we all know that human faeces contain bacteria and germs which consequently contaminate water people use for drinking,” he said.
According to him, in order to curb the menace of open defecation, government at all levels should increase public awareness on the health risk it poses to the populace. He noted that the practice could be stopped by government by exhibiting political will through construction of public toilets in strategic places as well as promulgating stringent laws on sanitation and proper waste disposal.
A medical epidemiologist, Dr Ope Osibogun, also explained that the environmental health risks of open defecation include the pollution of fresh water and lakes by untreated human waste, leading to reduced production of seafood and thus the reduction in animal protein and sources of vital nutrients.
“Open defecation would also reduce the amount of clean water available, thereby leading to an increased purchase costs for chemical and mechanical clean-up operation. The chemicals for the clean-up process, if not properly stored and handled, may lead to health hazards. The waste products from the clean-up process, if not properly handled, could also serve as major health hazards.
“Poor sanitation and exposure to open defecation can lead to diarrheal diseases in children which make them vulnerable to malnutrition, stunting and opportunistic infection such as pneumonia.
“It exposes members of the public to various infections such as cholera, schistosomiasis, trachoma, shigella, typhoid, hepatitis A, polio, amoebic dysentery, giardiasis, ascariasis, hookworm infection, tapeworm infection.”
Osibogun, who listed some measures government should take to avert related disease epidemics, said there was need to set up contact numbers for access to the public which they could call and report cases, and immunization of all children against preventable illnesses such as cholera and typhoid.
He encouraged people to drink and use safe water only. “Bury all faeces and do not defecate in any body of water. Cook food well (especially seafood), keep it covered, eat it hot”, he added.
Osibogun said there was need for people to construct pit latrines away from water bodies and, when full, covered them with soil and plants.