Open defecation is a ticking bomb in Homa Bay and Turkana

As we dock on the shores of Remba Island in Lake Victoria, we are greeted by a fusty stench of decay.

When we walk between the informal settlements, we notice the unsightly scene of abandoned bucket toilets, some full of human excreta, others spilling over.

In this tiny piece of land in Homa Bay County, the population reaches up to 20,000 people depending on fishing seasons but the scarcity of pit latrines means families are living in constant danger.

Going to the toilet isn’t a normal and spontaneous occurrence. It is a process that requires planning and calculations.

There are only four public latrines on the island, two of which are at the local primary school and are locked by their owners. Even the police post has portable toilets, and according to a government official who requested anonymity, when full, the waste is released into the lake.

On the available latrines are shallow holes that leak into the nearby lake, and the stench emanating from them is unbearable.

“We don’t have enough latrines and the ones here were built in the 90s by the county council. Currently, there is only one latrine built in 2020 and it is in a very bad condition,” reveals Dixon Oriaro, a resident of the island.

Furthermore, digging a pit latrine here is an extremely costly affair as the land is rocky and residents only settle for shallow pits which get filled up within weeks.

“These rocks have to be burnt before being split to pave way for these pits. This can cost up to hundreds of thousands of shillings, money which we lack,” explains Dixon.

In an effort to mitigate the crisis, back in 2016, the Rotary Club of Mbita, Mfangano Island, an international humanitarian organization based in the area, launched the Ecosan latrines project.

This consisted of Ecosan pay toilets for the community and Ecosan latrines for the school pupils and teachers.

“There were very few toilets on the island before. Most people were practicing open defecation,” explains Bernard Gor, former leader of the organisation.

“These bucket toilets were designed to separate urine and faeces, and ash and sawdust were to be added in the toilet after every use to draw moisture from the excretion, thus keeping away flies and reducing smell.” But along the way it was faced with serious headwinds, and after three years of operation, the project failed.

“After some time, they were so smelly that they became a nuisance to the society,” says Okoyo Waondi, secretary, Remba beach management unit.

These activities have proven to be a danger not just to the health of the residents of Remba Island, but also the marine life that surrounds them.

Back in 2016, a World Health Organization WHO report indicated that water from Lake Victoria was not safe for human consumption, and people living on its islands were at risk of cholera, typhoid and dysentery, as most of them drink water directly from the water body.

In Turkana County, Susan Esinyen and her family have been trekking for about 100 metres to a seasonal stream popularly to empty their bowels for the past six decades.

Susan, 63, has never known a latrine for her lifetime and the stream has been their preferred spot just as her neighbours at PAG 1 village in Kakuma town.

“If I needed to relieve myself at night, I would wake one of my children up to accompany me to the stream,” the mother of eight tells Healthy Nation.

The norm is replicated by all villagers, because “you cannot go alone at night as it is far.”

But that pain was only until October last year, when the county government in partnership with Peace Wings Japan came to the village’s aid to help them use latrines.

“We were provided with a reusable top cement slab by Oxfarm. A pit latrine was constructed with sticks and to enhance privacy draped old clothes,” she recalls.

Susan and her neighbours were also taught how to wash hands with soap after visiting the latrine.

“We are grateful because we are witnessing a decrease in diarrhoeal disease in the village because of latrine use,” she said.

Mrs Esther Apoo, a community health worker in charge of 50 households in PAG 1 Village has been an activist creating awareness on the importance of pit latrine utilization and hand-washing with soap since the county government adopted the community led sanitation in 2017.

“Before the pit latrine use and hand-washing, I used to attend to lots of cases of diarrhoea involving children under 5 years and also cases of cholera were many,” said Mrs Apoo.

“I was happy when early November PAG 1 village residents joined the other 228 villages in Turkana West including the two refugee settlements – Kakuma Camp and Kalobeyei Integrated Settlement - in celebrating a declaration as an open defecation free (ODF).”

“Turkana County has achieved ODF status in 583 of 2,249 villages the triggering and follow-up of the rest villages was ongoing until when Covid-19 pandemic disrupted but now we are back on track with awareness latrine use campaigns,” she said.

At the Kalobeyei Integrated Settlement, Mary Achan – a South Sudan national – has been living there for the last four years. The 62-year old grandmother, who lives with her two grandchildren, describes a time when they had no latrines as the worst of times.

“We used to have cholera outbreaks, diarrhoea, many cases of typhoid and even malaria because of the liquid waste,” she said, through translator David Orach, the Community Health Supervisor in charge of 42 villages in Kalobeyei 1.

In October 2021, like many of her neighbours in the village Mary constructed a latrine behind her house.

Previously, her household would regularly visit the clinic about three to four times a month because of diarrhoea or fear of getting cholera during the outbreaks.

Pastoral lifestyle, soil structure and socio-cultural traditions have also been blamed for the poor latrine use among the Turkana community.

According to Turkana customs, it is abominable for a daughter in-law to share a latrine with her father-in-law forcing either party to use the bush in relieving themselves.

Michael Ewatom* from Kanam village admits to having never used a latrine to relieve himself since his birth 75 years ago. “We have been socialized to always relieve ourselves in open ground. We are used to defecating in the nearby bushes especially along the river since the time we were born,” he says.

He states that the sandy soil is very loose for a pit latrine to be sunk and several attempts have been futile as they always collapse.

In Turkana, only 26 per cent of the entire population of 926,976 according to the 2019 census data have access to latrines as a huge population prefers open defecation.

WHO notes that over 3.6 billion people across the globe lack latrines and continue to live without access to safely managed sanitation.

“When some people in a community do not have safe toilets, everyone’s health is threatened. Poor sanitation contaminates drinking-water sources, rivers, beaches and food crops, spreading deadly diseases among the wider population,” states WHO.

WHO further notes for women and girls, toilets at home, school and at work help them fulfil their potential and play their full role in society, especially during menstruation and pregnancy.

Even though sanitation is a human right recognized by the United Nations, the world urgently needs massive investment and innovation to find progress along the sanitation chain, from toilets to the transport, collection and treatment of human waste.

According to the United Nations, at least 2 billion people use a drinking water source contaminated with faeces globally, translating to over 700 children under five years dying every day from diarrhoea linked to unsafe water and poor hygiene.

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