Wednesday, November 20, 2013

Essence of the World Toilet Day


World Toilet Day is observed annually on November 19. It was created in 2001 by World Toilet Organisation in response to the struggle of billions of people face every day without access to proper, clean sanitation. Also to bring to the forefront the health, emotional and psychological consequences the poor endure as result of inadequate sanitation.
Of the world 7 billion people, 6 billion have mobile phones. However, only 4.5 billion have access to toilets or latrines-meaning the 2.5 billion people, mostly in rural areas, do not have access to toilet and proper sanitation. In addition, 1.1 billion people still defecate in the open.
The countries where open defecation is most widely practiced are same countries with the highest number of under-five child deaths, high level of under-nutrition & poverty, and large wealth disparity.
World Toilet day is created to pose exactly those kinds of questions and to raise global awareness of the daily struggle for proper sanitation that a staggering 2.5 billion people face. The day brings together different group, such as media, the private sector, development organization, and civil society in a global movement to advocate for safe toilets.
Since its inception in 2001, World Toilet Day has become an important platform to demand action from government and to reach out to wider audiences by showing that toilet can be fun and attractive as well as vital to life.
It is in response to this, that United Nation general assembly on July 24, 2013 officially approves, endorsed and designates the day to spotlight the plight of 2.5 billion people who do not have basic toilet. The assembly resolution approved by consensus urges all its 193 members to promote behavioural changes and adopt policies to increase access to sanitation and end open defecation, a key cause of diarrhea.
Toilet in Nigeria leaves much to be desired. A simple visit to our houses, offices, markets, Relaxation Park, hotels will tells you the state of our toilets. People are also defecating and urinating indiscriminately along the road, in public places etc. without any shame, which rains washes it away to our water supply source, and the attendant consequences. The state of public toilets also are so poor that if you use some, you must take a good shower to free yourself from the sent and smell that stains both your body and dress. Many houses had no toilet at all, but only use the nearby space or bush, even the dead are not spared, as some do go to cemeteries to defecate and urinate.
According to the National Policy on Excreta and Sewage Management, 2005, it has been observed that, in urban centres, some households with water carriage system, pipe the raw sewage into the public drains. Also, according to 1999 Nigeria Demographic and Health Survey [NDHS], 12% of the urban population has no toilet facilities of any kind whilst, 55% use pit latrines and 31% use flush toilets. Rural areas are even less served. The NDHS 1999, also indicated that about one third of rural households have no toilets facilities at all and as a result make use of bushes and rivers. In the periurban centres, children as well as adults defecate indiscriminately at dumpsite, gutter or any available open space in the late hours of the night and early hours of the morning.
These figures are especially sobering as that a large number of people urinate in open spaces, with serious health implications in densely populated urban and periurban settlements.
Based on the above, the policy prescribe that every house shall have suitable and adequate numbers of sanitary latrines/toilets, it shall be built of hygienic easy to clean materials, accessible and designed to minimize the proliferation/harbourage of diseases, and shall be located to avoid potential contamination of waters sources and surface soil.
The minimum accepted numbers of persons per toilet as per the policy are: 1-10 persons, 1 toilet; 11-20 persons, 2 toilets; 21-40 persons, 3 toilets; 50-75 persons, 4 toilets; 75-100 persons, 5 toilets, but over 100 persons, one toilet to every additional 30 persons.
Since human faeces contain a wider range of disease-causing organisms including viruses, bacteria, and eggs of human parasite, and that many of these organisms are transmissible to people through houseflies, contaminated hands, food, water, eating and cooking utensils, and by direct contact with contaminated object, and that Infections such as cholera, diarrhea, typhoid, poliomyelitis, etc., that account for significant morbidity and mortality in developing countries such as ours, which are spread in this way, the importance of toilet cannot be overemphasized. In a situation where the toilet is not even unclean/unhygienic, its absence pose more dangers, as people defecate openly, which will give room for contamination of water source via rainstorm, offensive odour, etc.
The disease associated with excreta are, faeco-oral like cholera, dysentery, poliomyelitis, etc., soil transmitted helminthes like roundworm, whipworm, hookworm, etc., beef and pork tapeworm due to the eating of untreated excreta by cow or pig, water based helminthes like schistosomiasis due to frequent contact with faecal contaminated water and excreta related insect vectors like flies, cockroach and culex mosquitoe.
It can be seen that cholera and poliomyelitis are most common infections that keeps recurring in Nigeria, which their principal source of transmission is ‘faeco-oral’, and directly relates to excreta. And too much amount of money is being spent on cholera whenever it become epidemic with little or no impact, but only to control, and wait for the next time to will recur again. Instead of investing in the environment, in making sure each house has a hygienic and proper toilet, clean and healthy environment, no we prepare to rely on drugs only. The same with polio, unless we gives emphasis on environmental health and sanitation, the day to eradicate it will remain a mirage.
As we celebrate the day today, we should make sure henceforth to clean our toilet accordingly, covering its opening in case of pit larine, emptying it as at when due, and observing basic hand washing techniques after defecation, after cleaning babies bottoms, before food preparation, before eating; and before feeding children using detergents or ash.
The option before Nigeria in making sure all houses have toilets is Community Led Total Sanitation [CLTS, an innovative methodology for
mobilizing communities with a view to eradicating Open Defecation (OD)], Ecological Sanitation Toilets, reviewing of Public health laws to stipulate a stricter penalty for any house that has no provision of adequate and functional toilet, training and retraining of environmental/public health practitioners to engage communities on the importance of toilet and hand washing health wise, for the control of many diseases associated with excreta.
More awareness is needed for the people to appreciate the relevance of the day, and inculcate the importance of toilet in their life.
Sani Garba Mohammed, public health department[environmental health programme], Federal University of Technology, Owerri