Organization of Environmental Health Services: Directorate/ Department of Environmental Health and Sanitation

Environmental Health services play a pivotal role in health service delivery and concentrate on preventive and promotive health aspects which are vital for alleviation of current pressures on curative health services. Over the years, many definitions have been ascribed to Environmental Health. The World Health organization defines Environmental Health as the control of factors in man’s physical environment which exercises, or may exercise, a deleterious effect on his physical development, health or survival. Environmental health has been defined recently as comprising those aspects of human health, including quality of life, which are determined by physical, biological, chemical, social and psychological factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing these factors that can potentially affect adversely, the health of present and future generations. Environmental health programmes are organized community efforts to monitor and modify man- environment relationships in the interest of better health.

Some of the functions of Environmental Health include:

sanitation of the environment, inspection of premises, control of communicable diseases, disposal of wastes (i.e., garbage, general sewage and gaseous wastes including such special wastes like toxic and hazardous substances) potable water supply, good and sanitary housing condition, food sanitation, personal hygiene pests and rodents control, air pollution control, control o noise pollution, etc.

Environmental health plays a major role in disease prevention, control and the sustenance of environmental integrity. Therefore, as a broad concept in public health, it is ‘the science and art of preventing disease, prolonging life and promoting health through organized efforts of society. The outcome of environmental health activities is the prevention, detection and control of environmental hazards which affect human health.

The Goal of Environmental Health services

To improve the status of the environment in order to reduce environmental risk and promote healthy living.

Core Functions

Environmental Health Practitioners in Nigeria are appointed or employed under the Federal, State and Local Governments. However, the majority of the Officers are employed under the services of the Local Government Authority who has the primary responsibilities for the grassroots populace. In recent time, a few Environmental Health Officers have been employed in the Organized private sector (multinational petro-chemical industries) and consulting outfits. They are also employed in the military and

paramilitary formations. They carry out duties as specified in the Public Health Laws, Sanitation Law and Edicts, Food, Drugs and Chemical substances provisions among others. The Department of Environmental Health and Sanitation a leading role in the prevention and control of preventable diseases. The following are core functions of the Environmental Health Officers, which also constitute special areas (components).

The components of Environmental Health include:

i.             Waste management;

ii.          Food hygiene and control;

iii.        Pest and vector control;

iv.         Environmental health control of housing and sanitation;

v.           Epidmiological investigation and control;

vi.         Air quality management; occupational health and safety; water resources management and sanitation; noise control;

vii.       Protection of recreational environment; radiation control and health; control of frontiers, air and sea ports and border crossing;

viii.     Pollution control and abatement;

ix.         Educational activities (health promotion and education);

x.           Promotion and enforcement of environmental health quality standards;

xi.         Collaborative efforts to study the effects of environmental hazards (research);

xii.       Environmental health impact assessment (EHIA);

xiii.     Environmental and Public Health Laboratory Services;

xiv.     Disposal of the Dead (human and animals).

xv.       School Health Services (Sanitation)

In the Ministries of Health and Environment, the Directorate of Environmental Health Services (DEHS) is one of the oldest in the Public Health sector.

The Directorate of Environmental Health irrespective of its level of operations, should comprise the following divisions, namely:

1. Division of Environmental Sanitation;

2. Division of Environmental Health Data Management;

3. Division of Pollution Control;

4. Division of International Health & Port Health Services;

5. Division of Occupational Health and Safety;

6. Division of Environmental Health Education and Promotion;

7. Division of Epidemiology of Communicable and Non- Communicable Diseases;

8. Division of Emergencies and Response;

9. Division of Food Safety and Hygiene.

1. Division of Environmental Sanitation

i. Formulation and implementation of policies on health, hygiene and sanitation

ii. Maintenance of urban and rural sanitation;

iii. Maintenance of sanitation of dwellings, markets, public places, abattoirs, camps, exhibition grounds, park and informal settlements;

iv. Prevention and control of nuisances in the environment;

v. Promotion and co-ordination research on appropriate alternatives in sanitation and use of new technologies;

vi. Collaboration roles of partners and other stake-holders involved in implementing environmental sanitation and hygiene activities;

vii. Enforcement of Environmental Health Standards and Regulations

viii. Review of Environmental Health legislation;

ix. Promotion of waste analysis and segregation at source and safe re-use of wastes;

x. Promotion of safe disposal of wastes;

xi. Promotion and coordination of public-private sector partnerships in waste management;

xii. Development of guidelines/SOP on the management of Hospital/medical and electronic wastes;

xiii. Co-ordination of Integrated Pests and Vectors Management Activities;

xiv. Monitoring of activities of private sector pests and vector control service providers;

xvi.       Ensuring the safe handling and use of pesticides within the community.

xvii. Identification and mapping of ecological breeding sites of pests and vectors.

xviii. Ensuring continuous training and re-training of EHOs in the ecology, physiology of pests, etc.;

xix. While-on-the-job training and capacity building for control of insect pests, rodents and other vermin of Public Health Importance;

xx. Participate in planning of layouts, processing of building sites and plans.

xxi. Ensuring compliance with approved building plans as it affects health and safety issues;

xxii. Issuance of certificates of fitness for habitations and certificates of fitness for continued habitation or continued use of building and premises;

xxiii. Inspection of water packaging premises.

2. Division of Environmental Health Data Management

i. Participate in periodic monitoring, surveillance and evaluation of programmes in the directorate;

ii. Coordinate collection, collation, analysis, interpretation and storage of Environmental Health data;

iii. Conduct routine reporting, dissemination and feedback activities in environmental health management;

iv. Initiate periodic strategic planning processes in environmental health matters;

v. Coordinate Environmental Health Management Information system.

3. Division of Pollution Control

i. Ensure Public Health Safety of Water sources -- e.g., streams, rivers, wells, ponds, boreholes, pipe borne water, etc.).

ii. Conduct routine sanitary surveillance of drinking water quality.

iii. Map sources of contamination and pollution of water supply using Global Positioning System (GPS);

iv. Ensure safety of recreational water bodies -- e.g., swimming pools and beaches;

v. Remediate impacted sites;

vi. Prosecute polluters of water sources;

vii. Develop and application of assessment tools for pollution control;

viii. Enforce standards, rules, regulations and laws on pollution control;

ix. Liaise with stakeholders on environmental health monitoring;

x. Provide Environmental Health Laboratory support

4. Division of International Health and Port Health Services

i. Enforcement and implementation of International Health Regulations;

ii. Disease surveillance within the ports and frontier posts of entry and exit;

iii. Notification of occurrence of any diseases as required by national and international authorities;

v. Maintaining Environmental Sanitation including waste management within ports and frontiers; Ensuring Pest and Vector control within and around ports and frontiers;

vi. Ensuring food safety and hygiene at ports and land borders;

vii. Inspection of establishments

viii. Vaccination of certificates;

ix. Responding to any health emergencies within and around the port area;

x. Organizing periodic health education and promotion activities within the port;

xi. Ensuring compliance with relevant policies, rules, regulations and laws.

xii. Liaising with other stakeholders in the implementation of port health activities.

5. Division of Occupational Health and Safety

i. Ensure routine Inspection, detection and abatement of nuisances   in all work places.

ii. Ensure enforcement of use of safety devices by workers in workplaces.

iii. Ensure education/enlightenment of workers on safety regulations and standards.

iv. Conduct occupational health and safety assessments in work places.

v. Keep records of Occupational Health and Safety activities.

vi. Coordinate Health Safety and Environment (HSE) activities/programme in work places.

vii. Identify environmental health issues and challenges in relation to radiation, noise, air quality and EHIA.

6. Division of Environmental Health Education and Promotion;

i. Conduct periodic sensitization of the public on Environmental Health issues.

ii. Develop messages and sensitization packages for Environmental Health programmes;

iii. Develop and implement Environmental Health Education Behavioural change strategies;

iv. Develop and disseminate advocacy tool kits and education packages for Environmental Health Services.

7. Division of Epidemiology of Communicable and Non-Communicable Diseases Control

i. Identify local endemic diseases and health events.

ii. Institute disease prevention strategies.

iii. Participate in integrated disease surveillance and response.

iv. Investigate disease outbreaks and control.

v. Conduct disinfection and disinfestations.

vi. Map infected areas for disease control.

vii. Creation awareness on the signs, symptoms and prevention of diseases.

viii. Conduct hygiene and sanitation surveys.

8. Division of Emergencies and Response

i. Prediction and mapping of disaster prone areas.

ii. Risk forecasting and development of mitigation plans

iii. Identification and management of disaster and health emergencies.

iv. Collaborating with stakeholders in disaster and health emergencies.

v. Awareness creation on disaster management and control (including simulation)

vi. Establishment and updating of data base on disaster and emergencies.

vii. Predicting of environmental health risks due to climate change.

viii. Development of control and mitigation plans.

9. Division of Food Safety and Hygiene

a. Approval of food vending.

b. Inspection and licensing of food premises.

c. Annual approval and permitting for eateries, Cold rooms, butchers shops, fishmongers’ shops, and other food associated outlets.

d. Formulation of Food Safety Policy and implementation.

e. Food safety risk assessment, risk management and risk communication.

f. Surveillance on food borne diseases/illnesses.

g. Promoting food safety, quality and hygiene control

h. Awareness creation and Information dissemination to the Public on food safety.

i. Ensuring safety of genetically modified food for public use.

j. Conducting periodic surveys and operational research on food hygiene and safety.

k. Ensuring compliance with regulations guiding imported food items.

l. Collaboration with relevant agencies, (NAFDAC, Consumer Protection Council, etc.) to ensure the development, harmonization and enforcement of food safety standards.

m. Legislation on food hygiene and safety issues.

Staffing

The WHO recommends a ratio of 1:8000 (EHO per population) for effective Environmental Health Service delivery. There is need for adequate number of Environmental Health Officers in all prescribed Divisions at National, State and [GA to ensure effective service delivery. There were 6,200 EHOs registered in Nigeria as at December 2011. Considering the fact that Nigeria has a population of approximately 160 million persons (2011 estimate), this translates to about 1:26,000 (EHO per population). This number of EHOs is grossly inadequate. There is urgent need to train and employ more EHOs. Therefore, EHORECON recommends that the ratio of EHO to the population shall be 1:6000 in densely populated area and 1:4000 in sparsely populated area.

Source:  Practice Guide of Environmental Health Officers in Nigeria, 2012 published by Environmental Health Officers Registration Council of Nigeria [EHORECON]

EHTSA, celebrates 2014 World Water Day

Being a paper presented on the celebration of World Water Day by Environmental Health Technology Student Association, EHTSA, Federal University of Technology, Owerri on 22nd March, 2014.

Read by Celestine Onah

Despite the fact that water is one of the basic essential for life, it is a scarce commodity in many parts of the world as 20% of the world population lacks safe drinking water. Adequate water that is safe, wholesome, and potable is a necessity in life that will free human from diseases associated with poor, contaminated and inadequate water supply.

In Nigeria, access to safe water is a major challenge. According to 2008 WHO/UNICEF Joint Monitoring Programme, the proportion o f the population using water from improved sources has decrease by 3% from 1990 to 2006, the proportion of urban population with access to improved sources of drinking water decrease by 15% from 80% in 1990 to 65% in 2006 and in rural areas it reduced by 4% from the 34% in 1990 to 30% in 2006.

The decrease by 15% in 16 years is very significant considering the people living in urban areas increased from 30-49% from 1990 to 2006.

Also, the MDG target for Nigeria is 75%, but the facts on ground shows that Nigeria is not on track to meet the MDG target, and if it continues like this only 44% of people in Nigeria will have access to improved water sources.

World Water Day tries to remind people about the significance of fresh water and to promote sustainability for fresh water resources management. The day was first proposed in 1992 during the United Nations Conference on Environment and Development [UNCED], but was officially assigned to 22 March in 1993 by United Nations General Assembly. 

The 2014 theme is ‘Water and Energy’. Water and energy are closely interlinked and interdependent. Energy generation and transmission requires utilization of water resources, particularly for hydroelectric, nuclear and thermal energy source. Conversely, about 8% of the global energy generation is used for pumping, treating and transporting water to various consumers.

It is based on this that United Nation is bringing its attention to the water-energy nexus particularly addressing inequities, especially for the ‘bottom billion’ who  live in slums and impoverished rural areas and survive without access to safe drinking water, adequate sanitation, sufficient food and energy services.

Also it aims to facilitate the development of policies and crosscutting framework that bridge ministries and sectors, leading the way to energy security and sustainable water use in a green economy.

Environmental Health Technology Students Association [EHTSA], FUTO chapter enjoins us to celebrate the day and spread these messages:

Water requires energy and energy requires water

Water is required to produce nearly all form of energy. Energy is needed at all stages of water extraction, treatment and distribution

Supplies are limited and demand is increasing

Demand for fresh water and energy will continue to increase significantly over the coming decades. This increase will prevent big challenges and strain resources in nearly all regions, especially n developing and emerging economies.

Saving energy is saving water, saving water is saving energy

Choices concerning the supply, distribution, price and use of water and energy impact one another.

The ‘bottom billion’ urgently needs access to both water and sanitation services, and electricity.

Worldwide, 1.3 billion people cannot access electricity, 768 million people lack access to improved water sources and 2.5 billion people have no improved sanitation. Water and energy have crucial impacts on poverty alleviation.

Improving water and energy efficiency is imperative as are coordinated, coherent and concerted policies

Better understanding between the two sectors of the connections and effects on each other will improve coordination in energy and water planning, leading to reducing inefficiencies. Policy-makers, planners and practitioners can take steps to overcome the barriers that exist between their respective domains. Innovative and pragmatic national policies can lead to more efficient and cost effective provision of water and energy services.

We are also calling on Nigeria to improve on the current water supply coverage [44%] which is below the MDG target [75%], and provide all the necessary inputs for clean, safe, and potable water supply to the nation.

10 facts about Water, Sanitation and Energy

1                   900 million people do not have access to safe drinking water;

2                   2.5 million people do not have access to improved sanitation;

3                   Improve sanitation can reduced diarrhea morbidity by 32%;

4       5 countries has the highest number of people who practiced open defaecation: Nigeria, 34 million; Pakistan, 40 million; India, 626 million; Ethiopia, 38 million; and Indonesia, 63 million;

5       2.4 billion [equivalent to third of humanity] do not have access to advanced form of energy: electricity, liquid or gaseous fuels;

6          The growth of world population in 2 billion people over the next decades will increase the need for water by 44% and energy demand by 50% in2050;

7       The energy prevails among contributors to climate change, accounting for 60% approximately of total emissions of greenhouses gases worldwide;

8                   75% industrial water extractions are used for energy production;

9                   30% energy inefficiently or unnecessarily used in buildings; and

10              5 most energy consumer countries are: USA, 97.4^*; Russia, 32.7^*; India 23.6^*; China 109.6^*; and Japan 20.8^*. [* Total annual primary energy consumption, 2011, [quadrillion Btu]

Sources: UN water, United Nations, Energy House Publishing, Energy Information Administration. 

AN ADDRESS PRESENTED TO THE PRESIDENT, ENVIRONMENTAL HEALTH OFFICERS ASSOCIATION OF NIGERIA, DELTA STATE CHAPTER BY SANITARIAN CLINTON E. ONOVWEDE ON BEHALF OF THE ‘NIGERIAN ASSOCIATION OF PRIVATE ENVIRONMENTAL HEALTH PRACTITIONERS’ DURING HER MEETING HELD ON THE 11TH JANUARY, 2014 AT DON ROSS EVENT CENTRE, UGHELLI

It is a my pleasure and privilege to present this address to the President, Environmental Health Officers Association of Nigeria, Delta State Chapter on behalf of the Nigerian Association of Private Environmental Health Practitioners. I also wish to use this opportunity to congratulate the President and other members of the state executive on their well deserved victory.

Mr. President Sir, we are here today to inform you on a number of issues affecting the Environmental Health Profession with a view to finding lasting solution to them. The Environmental Health Officers are public health practitioners charged with the management of waste; food hygiene, pollution control, vector control, housing and environmental planning amongst others. According to World Health Organization (WHO), environmental health is made up of fourteen (18) components on which the profession was built. We can recall that in the time past and during the era of Sanitary Inspectors, the profession was given its due recognition in the scheme of things. Today, the reverse is the case. With the growing apathy of most of our members, many questions are begging for answers. “Where are our Sanitary Inspectors?”  This was the caption in “The Punch” newspaper of 26th September, 2013. The profession seems to be losing its relevance. Many graduates of environmental health are regretting why they read the course. To them, the future is bleak. What does the future hold for the practice of environmental health in the next 10 years and beyond? It is a well known fact that many states in the federation have not been employing environmental health practitioners. The population of unemployed professionals is increasing yearly. What do we think is responsible? Is it that we are no longer relevant or government is not feeling our impact, or our state's Environmental Health Officers Association of Nigeria, EHOAN and Environmental Health Officers Registration Council of Nigeria (EHORECON) are not up to the task of addressing the various challenges affecting us?

1.      We are of the opinion that the practice of Environmental Health in Nigeria is seen only in government owned establishments. The Environmental Health Officers Association of Nigeria (EHOAN) is an umbrella that is supposed to house all members (both public and private). However, it appears those in private practice have been neglected.

2.      On 24th September, 2012, the then Minister of Environment, Hajiya Hadiza Mailafia inaugurated ‘Environmental Health Practice Standard Monitoring Committee’ that they should “abate the nuisances consisting of business as usual, low work output, compromise of professional responsibility and integrity, corruption and loss of impact on the society to ensure that they impacted positively and perceptibly in their operational areas” and others. The committee consists of environmental health officers based in each state (five Environmental Health officers were assigned to Delta State) to monitor the practice of their members, the challenges and problems, impact and other things and report their findings to EHORECON. It is now one year and we would like to hear from you what progress has been made.

3.      The current (2012) guideline policy of National Primary Health Care Development Agency (NPHCDA) relegated us and gave out our duties to Community Health Extension Workers. What are our association [EHOAN] and the Council [EHORECON] doing about this? Many policy makers do not know much of our duties. 

In 2007 National Council of Health meeting, it was recommended that by the end of 2007, all healthcare and research facilities should put in place infection control systems. And that waste management committee must include head of the hospital or his representative, the heads of departments in a hospital, and their registered Environmental Health Officers in charge of waste management. By the end of 2007, the meeting also recommended that every healthcare and research facility, where none exists, shall create an Environmental Health Department/Unit manned by qualified professionals charged with the responsibility of environmental health services including waste management. By the end of 2010, every Teaching Hospital, Specialist Hospital and Federal Medical Centre (FMC) and other similar health care facilities with more than 200 beds shall provide within their premises, a modern incinerator and ensure the employment of adequate number Environmental Health Officers for effective management of wastes within their facilities, and many others. 

These and other recommendations were communicated to all Chief Medical Directors of University Teaching Hospitals and FMCs by Federal Ministry of Health. Delta state, like some others have not seen reasons why priority should be given to the profession. I perceived that some of these state governments would want the profession to grow into extinction. This is evident in the shortage of skilled professionals in most LGAs of the federation, the engagement of non professionals for Environmental Health Services. Some of the best aspects of governance like sanitary inspection which used to be standard practice before, have been relegated and we are the losers.

4.      Lack of awareness. Majority of Nigerians and our policy makers see environmental health simply as ‘Waste Management.’ Other environmental health issues are unknown to them. Why do we think it is only on waste matter that people associate our profession with, is it that we are not making appreciable impacts or we fail to show what our profession is all about? Does our EHOAN have a functional website and valid e-mail? Our Regulatory body-EHORECON has a website: www.ehorecon.org.ng , why is the page static for a long period of time? At this age where the world has become a global village, our existence on net is telling the world who we are, what we are, where we are and how we are. Unfortunately EHOAN does not own even a blog, let alone a website to communicate to the world what we are. 

EHORECON website has not been updated for over a year. Many icons are empty.  The only information I found on the website is 2013 council examination starting from 2-6th December, 2013 and notice of relocation of its office to its new location in Utako, Abuja.

5.      The structure and regulation of the profession is lax. This ranges from the training institution through the public practitioners to the regulatory body. Some of these training institutions are yet to be accredited by relevant authorities but they produce graduates each year. Training institutions are allowed to admit as many students as possible without consideration to life after school. Some of these training institutions produce Higher National Diploma (HND) graduates without NYSC discharge certificate. A sorry situation that has denied most Environmental Health Officers job opportunities. In job practice, the environmental health profession has been neglected to quacks, so many have infiltrated the profession and more are on the line. There is now Environmental Management Association of Nigeria. In a recent publication, they are now calling for the adoption of reduce, Reuse and Recycling (3R) strategies in waste management programme in the country. They have also called for the speedy passage of the Environmental Managers Registration Council of Nigeria (EMRECON) that is before the National Assembly.  This is a wake up call to The EHORECON. In the words of the Registrar, …….”.today, more than 80 percent of the sanitary inspectors registered across the country are above the age of 50, meaning that in the next 10 years we are going to be losing about 80 percent of them to retirement and this is not funny as their duties cannot be done by any other persons”. -Augustine Ebisike, Registrar, EHORECON, Daily Trust, 20th November, 2013. What has been done about this, with the thousands of the unemployed graduates who are registered Environmental Health Practitioners, paying fees for license renewal without jobs? The Environmental Health Officers Association of Nigeria is supposed to criticize the council but it is not doing enough. She is supposed to work on the issue of inaugurating board members. Imagine our profession with no board members in the past two years. Two good heads are better than one, they say. It looks things are falling apart in the profession of ‘Environmental health’ as there may not be ‘authentic executives’ of EHOAN (National) in Nigeria now. In Daily Trust newspaper, an advert on page 14 bearing EHOAN logo and signed by the duo of Nwokocha Ogbonna [Past PRO EHOAN] and Ahmad Yandeh Mairiga [immediate VP North-West]. They seem to be representing the faction that believes there was no any election at all in Port-Harcourt. They informed the general public and all EHO that those parading themselves as Executives of EHOAN are fraudsters and impostors, and that anybody that deals with them is doing so at his/her own risk. They also said that the Annual General Meeting decided that Trustee of EHOAN take charge of the association until further notice. With all the enormous challenges facing us structurally, educationally, attitudinally, mentally, financially, academically, our relevance that is at stake. Yet our leaders are not thinking of how to restore the battered image of the profession and re-launch it with vigour, zeal, commitment and dedication so that to it can take its rightful place in the scheme of things in Nigeria.

Our dear President, we are very much aware that some of these issues raised are national issues, but we believe that we can work with you so that we can have a vibrant and committed body like Nigeria Medical Association (NMA) and to chart a new course for the development of the profession.

Long live Environmental Health Profession.

Long live Federal Republic of Nigeria.                                                             

Thank you all,

Comrade. Clinton Elohor Onovwede (Sanitariant),

Registered & Licensed

Registrar, EHORECON, interacts with students

By Sani Garba Mohammed

The Registrar, Environmental Health Officers Registration Council of Nigeria [EHORECON], Mr. Augustine Ebisike visited School Of Health Technology, Federal University of Technology, Owerri, and interacts with all students of public health, and precisely final year students that chooses environmental health and safety option.

In the interaction, the Registrar traced the historical background of environmental/public health practice in Nigeria as a nomenclature that has changed over time from Nuisance Inspector of the 1930s to the Sanitary Inspector of 1950s and 60s to Public Health Superintendent of the 1970s and to the present Environmental Health Officer, which is in conformity with what is obtainable internationally, discussed the current state of environmental health practice in Nigeria and what his council is doing in uplifting the profession to its rightful place in the scheme of things in Nigeria.

He also talked about the regulatory functions of EHORECON which include determining the standard of knowledge and skill to be attained by persons seeking to become members of the profession of Environmental Health Officers and improving the standard set from time to time; securing the establishment and maintenance of a Register of Environmental Health Officers and publication of such register from time to time; and many others as specified by the act establishing the council.

“A career in Environmental health is both rewarding and challenging” said the Registrar, thus graduates of the discipline will be very suitably equipped to take on gainful employment in the following areas, public health related agencies and environmental sanitation parastasals, pollution monitoring and controls outfits, disease surveillance units/establishments, research institutions, public health department of state and federal ministries of health, public utilities, agencies concerned with food inspection, standards, disease control vis-à-vis immunization programmes, private establishments and independently operated laboratories/ and referrals units for the analysis of environmental samples such polluted water, food [cooked], confectionaries/bakeries etc, establish private outfits in different areas of public/environmental health management, and many others.

The council also promised to facilitate employment of first class graduate of public health in FUTO to augment the shortfall of manpower.

Students expressed happiness over the visit to interact with them and find out more about their chosen profession and what the future holds.

Abea Canice said “Though a new student, but I am happy to have chosen public health as my undergraduate course, which have many interventions to offer in providing solution to Nigeria’s health problems”.

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