Henry Uche

World Toilet Day (WTD) is an annual global event organized by United Nation-Water, commemorated every November 19 to raise awareness of the crucial role that sanitation plays in reducing disease and creating healthier communities.

It focuses on the importance of sanitation and aims to raise awareness about the 2.6 billion people (nearly half the world’s population) who don’t have access to toilets and proper sanitation.

Nigeria takes the lead in open defecation globally, with its attendant health consequences. According to UNICEF, about 47 million Nigerians practise open defecation. As a Public health practitioner, in this interview with a medical practitioner, Asomugha Noble, of Babcock University Teaching Hospital, Ogun State, he gives insight into the issue with Nigeria leading in open defecation. 

The theme for this year’s commemoration is “Leaving No One Behind”. 

What is your view on the theme of this year’s commemoration?

I must say is a very commendable theme for this year’s WTD. Many Nigerians (Africans at large) do not deem it necessary to have good toilet facilities built in their residential and work places. Many people think it’s waste of resources to do so because there are so many alternatives. However, these “so many alternatives” are not healthy. Most diseases we suffer today such as typhoid and cholera can be linked directly or indirectly to poor toilet facilities. Therefore, “leaving no one behind” as the theme is aimed at properly educating every single Nigerian, both young and old on the importance of having good toilet facilities.

What could have made Nigeria to take the first position in open defecation?

The problems of Nigeria that makes her take the first position in open defecation are multifaceted and not until these issues are attacked, the campaign against open defecation may continue for a longer time without meeting desired results.

Open defecation is a human practice of defecating outside/ open environment rather than inside a toilet. People may choose fields, bushes, forests, ditches, streets, canals or other open space for defecation.

Some factors that result in the practice of open defecation in Nigeria and African countries are: Lack of or insufficient toilet facilities; uncomfortable, dirty or unsafe toilets as can be seen in public toilets. Others are cultural factors, lack of awareness, disease conditions (such as incontinence), social norms, combining open defecation with other activities such smoking, and so on.

Most houses do not have toilets. What does this portend?

Open defecation is not just an act of indiscipline but also a bad practice of grave public health concern, and to mention the fact that most houses don’t have adequate toilet facilities while some totally lack same is; inhuman. Every residential building, office place, markets, etc are supposed to have adequate toilet facilities to serve the number of people using that building. There are rules for toilet and washing facilities.

Workers have a right to “welfare facilities”. These include toilets and washbasins. Businesses with one or more staff must have these basic items.

There are circumstances when businesses may not have to offer toilets and washing facilities to staff. For example, issues such as physical difficulties, cost, trouble and time may prevent the installation of toilets. But employers should not regard these as potential excuses. They should make every reasonable effort to have toilets and washbasins on hand, even during a period of short-term work.

The Workplace (Health, Safety and Welfare) Regulations 1992, cover the supply of toilets and washing facilities for staff. The Health and Safety Executive (HSE) has a code of practice based on the law that explains the full requirements.

The law states that toilets and washing facilities must be adequate. Because the word “adequate” is open to interpretation, the HSE clarifies what it means: Employers should arrange for separate facilities for men and women. If this isn’t possible, toilets and washing facilities must have locks. These ensure privacy and security. The facilities must be clean and easy to maintain. Walls and floors should be waterproof.

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Toilets and washing facilities should have both cold and hot running water. They should have soap or a similar cleaning product. And a hot air dryer or paper towels should be available. Washing basins must be a reasonable size. People should be able to wash hands and forearms in them. The toilets should have toilet paper. In the female toilets, there should be a disposal point for sanitary dressings. The facilities must have ventilation and light.

The law says that workers should not have to queue for long periods to use toilets and washing facilities. To clarify this point, the HSE quotes minimum toilet numbers per employees.

For women only or for mixed use, there should be one toilet and washbasin for one to five employees. The number of toilets and washbasins then rises according to the total staff. For example, 25-50 staff should have three toilets and three washbasins between them. And 76-100 employees should have five toilets and five washbasins.

For men only, there should be one toilet and one urinal for one to 15 employees. This rises to two toilets and one urinal for 16-30 staff, and four toilets and four urinals for 91-100 staff.

Disabled workers require toilets and washing facilities that meet their needs. Large cubicles with supports and low hand basins are essential. Under the law, an employer must provide suitable facilities for disabled staff.

Some work sites are temporary. This applies particularly to the building industry. An employer must provide running water and flushing toilets if it’s reasonable to do so. An employer should not assume workers could use nearby public toilets.

If there’s no running water or plumbing, an employer should consider using chemical toilets. In these circumstances, washing facilities can be water containers.

Lagos in particular, we have seen houses with one or two toilets, some of these houses are two-storey buildings where five rooms occupied by not less than 25 persons use only one toilet, why do house owners find it difficult to put up this very important facility and it seems the government has little or no control or influence over land developers/landlords.

Well, it is not new to us that many property owners who collect rents from their tenants find it very difficult installing good and adequate toilet facilities, however such acts are condemnable to every sane mind, this points to one of the leading factors of open defecation which I earlier pointed to.

As for the government having control over these property owners, I can’t really tell. But the environmental protection laws are there, I have seen a lot of times the environmental sanitation agents went house to house to check for neatness and probably fined defaulters but I can’t really tell if or not they paid attention to toilet facilities. Generally, enforcement of these environmental protection laws is really a big setback and is directly or indirectly of great public health concern.

If you are one of those who hit the streets very early in the morning on regular basis, you must have seen people defecating in any available space in the neighbourhood, this underscore why Nigeria leads, others follows in open defecation globally.

Some persons avoid contracting infections from contaminated toilets, hence, resort to open defecation. What do you think can be done by landlords or governments?

Some of these issues are just very simple and straightforward. The house owners need to provide sufficient and adequate toilet facilities, considering the number of people in their buildings.  On the part of the government, it is important that houses are supervised from time to time, building plans should be approved by the government and the environmental sanitation agents should shun bribery and corruption if ever they are being faced with such. The government can as well provide public toilets along the streets to serve people who for one or two reasons couldn’t empty bowels at home before leaving. And on the part of the tenants, they should be made to understand the long term and short term implications of open defecation, hence the theme “leaving no one behind”. Attitudinal change on the part of everyone is what we need.

Despite all the campaigns against this uncivil practice, the act persists, why?

If a house is on fire, you can’t probably quench the fire by pouring water from outside. Someone must get to the source of the fire and quench it there. Getting a lasting solution to any problem is all about attacking it right from the source. If the causes of open defecation as earlier mentioned can be attacked, this menace will greatly reduce.

As a nurse, I have always believed that prevention is better than cure. The cost of preventing diseases has always been cheaper than the cost of curing. A situation whereby someone who has cholera defecates into a stream in community A, this stream also supplies community B. Members of community B use the tributary of the stream coming from community A. A few days later, it is announced that there is outbreak of cholera in community B, before help can arrive three children are already dead. When there is an outbreak which could have been prevented, what is the cost of treating a whole community compared to the cost of fixing good and adequate toilets? Can the lives of those who have died be equated to the cost of fixing good toilet facilities?? We can go on and on enumerating these things. Let all hands be on deck today to put an end to open defecation today.