…The 47million people causing it and the premature deaths
By Chioma Obinna
Nature is inescapable. When it calls, no one has the ability to refuse. But could this be the reason many Nigerians respond in the most disgusting way that could attract negative implications apart from portraying humans as the worst animals on earth?
Today, it is commonplace to find human faeces in open spaces even in the best cities across the country.
From the backyard of an average compound in Nigeria, to public places such as railways, motor parks, airport terminal buildings, filling stations, footpaths, highways, street roads, playing grounds, prayer houses, forests and stadiums, there is faeces everywhere.
Unfortunately, this common act has earned Nigeria the rating as the country with the largest number of people that defecate in the open in Africa and second largest globally after India.
According to the 2018 National Outcome Routine Mapping, NORM, Report, 47 million Nigerians defecate in the open while the country loses N455 billion (US$ 1.3b) annually due to poor sanitation.
Sunday Vanguard examines the problem and how it is affecting Nigeria’s economy and the people.
Unarguably, adequate sanitation with good hygiene and safe water are fundamental to good health, and social and economic development. This is why, in 2008, the Prime Minister of India quoted one of his predecessors, Mahatma Gandhi, as saying in 1923, “Sanitation is more important than independence”.
To Ghandi, improvements in one or more of these three components of good health can substantially reduce the rates of morbidity and the severity of various diseases and improve the quality of life of many people, particularly children, in developing countries like Nigeria.
Every society is recognized based on how it responds to, and manages human waste. But how true is this in Nigeria of today?
It is common to see people selling foods, sleeping, eating and drinking beside human faeces in Lagos and across the 36 states of the federation.
Several questions have been raised on why many Nigerians engage in open defecation. Sadly, there seems to be no definite answer to these questions. While some claimed open defecation is due to poverty and lack of government support in providing toilet facilities, in cases where the facilities are available, people still end up defecating in the open.
A case in point is Mr. Emeka Agwuenyi who told Sunday Vanguard that, even with his education, he cannot quit doing it in the bush.
“I cannot afford to do it in a small room always. I don’t enjoy using toilet in Lagos. This is why anytime I am in the village I feel free doing it in the bush,” Agwuenyi said.
Like Emeka, many people claimed doing it in the open gives them a kind of fulfilment, freedom and joy. Others do it due to cultural beliefs such as “it is forbidden to share toilets with women of reproductive age.”
Emeka and the rest of the 47 million Nigerians who do it openly must have been doing so out of ignorance of the implication of their action. Experts say regardless of the reasons to justify their actions, if human faeces are not handled properly, it can cause serious health challenges to public sources of water supply.
Open defecation, according to experts, is the emptying of bowels in the open without the use of properly designed structures built for the handling of human waste such as toilets.
The World Bank Statistics show that regions with high rates of open defecation experience a tremendous problem in terms of sanitation and proper waste management.
According to the World Health Organisation, WHO, open defecation can lead to serious negative effects on health and the environment.
The effects of open defecation, according to experts, leave much to be desired. According to the United Nations Children’s Fund, UNICEF, open defecation is associated with water-borne diseases.
When open defecation is done near waterways, it is carried into the water system. The contaminated water ends up in the main water source. When people use this water as it is for drinking and cooking, it results in water-borne diseases such as cholera, typhoid and trachoma.
Open defecation is also linked to vector-borne diseases. Experts say apart from water-borne diseases, when the human waste collects into heaps, it attracts flies and other insects. These flies then travel around the surrounding areas, carrying defecate matters and disease-causing microbes when they then land on food and drinks that people ingest unknowingly. In such cases, the flies act as direct transmitters of diseases such as cholera.
According to public health experts, a sad fact about disease transmission caused by open defecation is the cyclic nature of problems that victims begin to manifest. The most common diseases caused by this unsanitary act are increased cases of diarrhoea, regular stomach upsets and poor overall health. With diarrhoea, for instance, it means that people cannot make their way to distant places due to the urgency of their calls of nature, so they pass waste close to where they have their bowel attacks.
It simply ends up creating more of the same problems that started the disease and, in turn, leads to more people contracting more diseases and fewer people using the facilities. The result of this is more sick people and more opportunities for the disease to spread.
Open defecation is also linked to malnutrition in children. Once a child is a victim of one of the diseases passed on due to the lack of proper sanitation and hygiene, they begin to lose a lot of fluids and a lack of appetite for food. As a result, it gives rise to many cases of malnutrition in children.
Meanwhile, the situation is worsened by intestinal worm attacks passed through human waste. Altogether, these problems lead to stunted growth and weakened immune system that makes the child more susceptible to other diseases such as pneumonia and tuberculosis.
The environment also suffers as a result of open defecation, because it introduces toxins and bacteria into the ecosystem in amounts that it cannot handle or break down at a time. This leads to build-up of filth.
The load of microbes can become so great that, in the end, they end up in aquatic systems thereby causing harm to aquatic life.
Cost of open defecation
According to 2018 NORM Report, 47 million Nigerians do not have any toilets and another 75 million use unimproved toilets. These Nigerians, including vulnerable women and children, suffer as a result of ingesting contaminated water or food and living in unsanitary conditions.
Presenting the report carried out by the National Bureau of Statistics, NBS, Federal Ministry of Water Resources and the United Nations Children’s Fund, UNICEF, at a media workshop in Port Harcourt, UNICEF Chief of Water Sanitation and Hygiene, WASH, Mr. Zaid Jurji, explained that Nigeria loses N455 billion (US$ 1.3b) annually due to poor sanitation.
Jurji said the losses constitute one percent of Nigeria’s GDP.
“Open defecation costs Nigeria over US$ 1 billion a year (the GDP of Gambia)”, he added.
According to him, without toilets, people are forced to defecate in the open, leading to exposure to diseases such as diarrhoea, cholera, viral hepatitis, typhoid, polio, dysentery,
The UNICEF chief blamed the losses on premature deaths, health care costs and reduced time and productivity.
Jurji, who lamented on the serious implications of open defecation on Nigeria, said the new report also revealed that 90 percent of the 122, 000 Nigerians, including 87,000 children under five who die each year from diarrhoea is directly attributable to lack of WASH.
According to him, Nigeria has remained on the list of top five open defecation countries in the world for the past 15 years, moving from 5th place in 2003 to 2nd place in 2015.
He regretted that findings show that only 1 in 4 Nigerians has access to basic toilets.
“Frequent episodes of diarrhoea and other WASH-related illnesses lead to stunting, wasting and malnutrition, which severely affects children’s development,” he stated.
On the way forward, Jurji, who tasked the Nigerian government to invest more in WASH, said Nigeria needs only N95.9 billion per year to eliminate open defecation.
The UNICEF chief said the country could achieve economic gains as high as N359.1 billion (US$ 1.026 billion) annually from the N455 billion it loses due to lack of sanitation.
According to him, there is need for the country to prioritize sanitation on the federal and state government agenda and declare a state of emergency in the sector.
He said, as a way out of the problem, government should initiate bills/laws to promote sanitation and take urgent action to implement Open Defecation Roadmap.
Noting that Nigeria needs a total of N234 billion to attain open defecation free, he called for a separate budget line for sanitation.
Jurji regretted that statistics available show that more people have access to a cell phone than toilets in Nigeria.
However, critical health watchers believed that the solution to open defecation requires the involvement of individuals, households, and government. While they called for the provision of adequate toilets and water, they stressed the need for education and awareness to correct the natural norms and beliefs of the people.