The family without a toilet: Our 'hell hole' in Mukuru kwa Njenga slums

A ditch filled with dark water flows with a repulsive stench towards houses at the Mukuru kwa Njenga slum in Nairobi. A man is trying to fix some water pipes in it but he seems overpowered by the flowing water and lets it flow.

Slabs of destroyed houses now act as depressing keepsakes. Iron-sheet houses made from the roofing of previous stone-walled houses are the new shelters for most homes. A makeshift bridge made of remains of wood from the dilapidated houses has been erected to ease movement from one side of the ditch to the other.

As a stranger, you notice one thing — that a toilet is a luxury that most homes have forgone — not because they want to, but because they can’t afford it and are unsure of their fate on how long they will be allowed to live there. Here, the scars of demolitions still have open wounds whose nursing may take years. Almost a year later, stone relics are still outside Judith Adhiambo’s new home.

A few sugarcane plants are thriving just outside her tin-sheet house. Judith, 50 has nine children. She lives with seven of them in a single room. Her last child is 10, and when the Healthy Nation team visited, she had gone to school. Her 24-year-old son, whom we found tending to his dogs, stepped out when we arrived. After the big bulldozer came and left their house in shambles, he had to quickly put up some shelter. 

He is supposed to be in school but his mother can no longer afford school fees. The demolitions, which started in October last year, were linked to the government’s plan to expand the road for the Nairobi Express Way. However, some officials in charge of the demolitions went overboard and extended to areas that had not been mapped out and given an eviction notice. Consequently, some officers manning the operations were interrogated but the residents’ rights remain violated. Other allegations link the disputed land to a private developer even as residents say they have been living in the area for four decades. 

As countries mark the World Toilet Day this week, all they ask for is a pit latrine to be dug in different areas. This will save the river where they empty their waste from pollution. 

Judith remembers the night that she last owned a toilet.

“I thought I was in a bad dream. I thought I would wake up and laugh it off. I wasn’t asleep. It wasn’t a dream. I didn’t laugh it off. I remember taking my children and only a few belongings and running away for my safety, no one could hear my plea. It hurts, it still does…why?”

Her question remains unanswered. Judith’s husband, whom they moved to Nairobi together with since 2000, has since been suffering from a mental illness and his mental state was affected by the demolitions.

“He started taking drugs until they got into his head. He went for a check-up in Mathare and when he came back, he was still not okay. He is now in the village and I am all alone here in the city with children to take care of,” she says.

Judith has no formal job. Except for two of her eldest children. They all stay together in a house with no toilet. Her school going children like it when it is on a school day because the tussle for looking for a willing neighbour just to ease oneself can be daunting.

She has to budget for her toilet visits. One latrine visit for a family member costs Sh5. If all family members go to the latrine in one day for just one visit, it costs them Sh50; woe unto them should there be a family member who has diarrhoea and has to visit the toilet more than once. 

The neighbour’s toilet, which they use and pay for, is however not a guarantee, but dependent on his availability.

“When our neighbour, whose toilet we use, is not around, we have to improvise. If we are just family, the member who is pressed usually requests the other to step out so that they can ease themselves. We have a tin, which acts as our toilet when push comes to shove. If it is a short call, it is easier because we pour it outside. Should it be a long call, the drill is the same only that we have to let faeces dry in the sun for disposal mostly at night,” Judith says.

“We sometimes wish that we don’t get visitors. What if the visitor wishes to visit the toilet? What if I become pressed and my neighbour is not around? Will I ask my visitor to step out so that I can ease myself? It is embarrassing to say such a thing,” she says.

The family has luckily never had diarrhoeal episodes that need the latrines attention at the same time. However, when the girls in her house are menstruating, it becomes even harder for them. They keep the used sanitary towels in the house.

We find Anifa Angulu, who lives a few metres from Judith’s home, holding her baby while having a light banter with friends outside her father’s house. Before the demolitions, her father, who died less than two months ago, owned rental houses.

All that was razed down by the government’s machineries. The man remained hopeless, and astounded that he had a stroke that eventually killed him. For about eight months after the demolitions, he became paralysed and could barely move. His family too did not have a latrine. Anifa was expectant when their toilet was taken away from them. 

She lost a necessity that she did not think would become too hard to find one day. She had to programme her days and knew when to go to the toilet. She had to be careful where to go to the toilet not to get any infections that could have affected her and the baby.

“My father died without having used a toilet after the demolitions. He was always in the house and we could bring him a bucket to use as the toilet and then dispose of the remains at a place that we found convenient. We have always depended on other people’s toilets, if they are not around, we suppress the urge until we get a toilet,” she tells Healthy Nation.

After her father’s death, well-wishers who trickled in for burial arrangements dug a hole, cemented it and it now acts as a toilet. The hole is not deep and is bound to get filled up with faecal matter and water so fast because it has neither a roof nor permanent structured walls. At the back of their model of a toilet is a pipe that once in a while is opened to release some of the faeces especially when it rains.

“This is all we have. It is expensive to call people who deal with latrines to help us empty our ‘latrine’. When it rains, we let it flow with rain water,” she says. Anifa is not sure how long she should do this. She can only hope to get a better toilet. As we walk past her house, we pass by remains of toilet bowls whose work has since become obsolete. 

Major problem

The chair lady of the Nyumba Kumi initiative; Anna Naseku, shows us where a toilet had been erected before the demolitions and it has now become a new house.

“I have lived here since the 80s, we have had issues before but since the demolitions, which happened last year, we have a major toilet problem. If any government official will read this, please help us build toilets. We are now living like village people since we now openly defecate and hide our mess with grass or soil,” she says.

Eric Ambuche, the founder of Slums Outreach Programme, says there is need for proper sanitisation because, already, the people living there are still tending to the wound of their houses being brought down by the previous government.

In August 2017, Mukuru kwa Njenga was gazetted as one of the slums in Nairobi that were part of the Special Planning Areas in Nairobi County. 

A study published by the International Institute for Environment and Development shows that minimal participation by local community members hinders the actualisation of such plans.

“Mechanisms for citizen participation in urban planning processes are historically weak, amorphous, and not clearly provided for in Kenyan legislation. This leaves ordinary residents with little influence and control over land allocation, settlement planning, and service and infrastructure provision,” highlighted a study published by the International Institute“

Efforts to push for changes at higher levels, experts say, must be accompanied by establishing horizontal support structures. The more residents support a scaling process, the more likely it is that such an initiative can be successfully implemented. It remains paramount to continue working locally by promoting efforts to scale within informal settlements. 

In his inaugural speech, Nairobi Governor Johnson Sakaja promised to restore the sanity of Nairobi County’s sanitation. While his main focus was on garbage, there is a silent crisis on unavailability of key household amenities like toilets that also need to be addressed.

Open defecation has devastating consequences for public health. Faecal contamination of the environment and poor hygiene practices remain a leading cause of child mortality, morbidity, under-nutrition and stunting, and can potentially have negative effects on cognitive development.

According to Centres for Disease Control and Prevention (CDC), open defecation, where people have no choice but to go outside, contributes to faecal contamination of the environment, which is one of the main causes of diarrhoea that  results in the deaths of more than 800,000 children under age 5 every year.

Kenya is one of 26 countries that are responsible for over 90 per cent of the global burden of open defecation. In 2021, fewer than three in 10 people in Kenya had access to a hand-washing station, according to the United Nations.

Studies indicate that an estimated 5.6 million Kenyans defecate in the open. This exposes them to sanitation related diseases. More than 17,000 Kenyan children under the age of five die from diarrhoeal diseases directly attributed to poor water, sanitation and hygiene.

In 2010, the United Nations included sanitation as a basic human right, which is still not afforded by some people. This has been highlighted in a study published by the scientific journal BMC Public Health, which broadly explains the negative impacts of open defecation, especially to women and girls.

“The UN assert that sanitation has to be considered beyond the scope of just considering health, housing, education, work and gender equality but instead should be considered in terms of human dignity in that open defecation evokes feelings of vulnerability and shame and this infringement to human dignity should be considered a human rights issue,” said the BMC study.

The study highlights that women are likely to face different challenges when they do not have toilets such as risks of sexual harassment, threat to privacy and dignity as well as psychosocial stress.

“The review identified that open defecation promotes poor health in women with long-term negative effects on their psychosocial well-being. The health and social needs of women and girls remain largely unmet and often side-lined in circumstances where toilets in homes are not available,” explains the study. 

Pregnant women who practise open defecation have a 24 per cent likelihood of getting hookworm infestation compared to six per cent for those who use toilets.

“Women and girls are often disadvantaged because of different sociocultural and economic aspects that deny them equal rights with men. Not only do they have different physical requirements from men but they also have an additional need for privacy and safety when it comes to their personal sanitation,” said the study.

Findings also revealed that activities like walking long distances in search of suitable sites to defecate and carry water is an indication of additional burden, which can be physically stressful and challenging to women, while living in conditions such as Judith’s and Anifa’s present an equally unnerving sanitation experience.

[email protected]