With regard to the practice of defecation by choice, the study above has revealed the following as the basis of such election to resort to open defecation. People often do so as a result of socialization, which mostly involves group activity by age groups in the villages and outskirts. This is mostly obtainable in sub-Saharan Africa. In this wise, It is common to find that people of age groups prefer going to open spaces simultaneously to practice open defecation. This is because this enables them close interaction in the process. This practice features mainly in the early mornings or in the process of going to the farms. The interesting thing is that, at times, some members of the social group even hold the call to nature in order to court the company of others for the purpose of eventual discharge with their friends.
Habit is another basis of the practice. Some people that practice open defecation often do so because of the 
practice over time that has now become part and parcel of them. In such instances, even where there is provision of an alternative, they will ignore the usage of the facility in preference for open defecation that has become their habit. Tailored to this is the difficulty of adjustment to the new toilet structure, which in most cases is not only novel to them but foreign. Again, some choose to continue with the practice of open defecation because of the freedom it gives them. Unlike the modern toilet system that restricts the user to certain boundaries, open spaces do not only afford them unlimited space in most cases but offers them daily choice. It is a major incentive for the preference of open defecation over the use of modern toilets. Religion is another factor that plays a prominent role in the choice made by certain practitioners of open defecation. Some people have ventilated the view that the location of toilets within the residential apartment is not good for sanctity of their homes perceived as a religious centre. They cannot fathom how the stench or the possible odour will be compatible with the presence of God in such places. The purity of such environment, to them, is also questionable. In addition, how can you be drinking water derivable from such residential spaces when the toilet cohabits with the structure? As far as they are concerned, it is like harbouring impurity in their vicinity. Consequently, it is always best to take a distance and preferably in the open, to defecate. The air dispels the odour and the faeces does not percolate the soil so as to contaminate their water.
In respect of the situation of people without a choice than to practice open defecation, the study unveils the followings as factors responsible for the practice of open defecation. As indicated earlier, lack of alternative accounts largely for this. Most people interviewed under this head will categorically state lack of resources both in terms of resources to provide alternative toilet or the land to construct such toilet on. Consequently, in the absence of such alternative, they do not have a choice than to patronise open spaces for defecation. In addition to the foregoing, where they even struggle to construct a toilet, they lack the wherewithal to maintain such structures. The cost of maintaining the infrastructure as well as continuous sanitisation of the toilet is usually beyond the reach of the majority of the people that engage in open defecation. In the absence of such maintenance capacity, the toilet environment stinks and odours become offensive. Therefore, they prefer to make use of open spaces for defecation. There is also the belief in some communities that toilets are meant to be reserved exclusively for special guests, male members, elderly people, or used only at night for safety and convenience of the users.
Another militating factor against the voluntary usage of toilets is the culture of the people. In some clans, it is forbidden for the father-in-law to use the same toilet with daughter-in-law. Similarly, in some others, men and women cannot use the same toilet. Consequently, where there exists a single toilet, women are often excluded from using the toilet. Furthermore, in instances where all that is available are public toilets, sited at a distance, people are usually discouraged from going to use the facilities, both for their security and the distance to be covered. Beyond this factor of distance, queuing is another challenge, particularly where such people are under immense pressure to defecate. Perception issue of the unhygienic nature of public toilets also encourages open defecation. There is the public perception of public toilets as a centre for dispersal of diseases, hence discouragement towards the usage. I must readily admit that, at times, the fear in this regard is real. Due to the bad sanitation practice around public toilets, it is susceptible to the spread of diseases. Increased risk of sexual exploitation, threat to personal dignity and privacy, psychosocial stressors, etc, arising from the insecure location of these toilets discourages the usage of the toilet facilities and imposes on the people the practice of open defecation. Finally, in this respect is the privacy issue. Women generally prefer their privacy when it comes to defecating. In some instances, they are equally uncomfortable with the presence of men, for safety reasons. The foregoing are the various reasons why people resort to open defecation, and same reasons shall ultimately form the basis of our prognosis later on.
Having demonstrated the reasons for the continuous practice of open defecation, it is now important to discuss how the practice affects us generally. This will substantiate and justify our initial thesis on the need for this excursion and the compelling reason for government intervention. By way of general assertion, the health impacts of open defecation are more felt among children and the womenfolk. According to studies, they are the most vulnerable in this respect. Again, although the negative impact of open defecation is felt more in rural settings, it is equally impactful in urban areas where the practice occurs. In a research article by Isaaka Kanton Osumanu et al, titled “Determinants of Open Defecation in the Wa Municipalty of Ghana: Emprical Findings Highlighting Sociocultural and Economic Dynamics Among Households,” published in the Journal of Environmental and Public Health, “though open defecation is predominantly a rural phenomenon, it is estimated that 8.22% of the urban population in sub-Saharan Africa practice open defection. The practice of open defecation in urban areas needs attention because research has shown that detrimental health impacts (particularly for early life health) are more significant from open defecation when the population density is high…”
The import of this is that the catastrophe capable of happening in the urban area as a result of open defecation is more due to the population density. Any minor trigger of cholera, for example, could lead to epidemics generating more fatalities than in rural areas. This is due to the fact of congestion in urban areas than in rural areas, with large spatial distribution. The infection is more aggressive in urban areas than in rural settings. As said earlier, open defecation has great effects on our health. The negative health impact is often associated with water-borne and vector-borne diseases. Examples are typhoid, cholera, hepatitis, polio, dysentery, trachoma. Malnutrition in children is another potential health hazard of open defecation. Highest number of deaths of children under the age of five are attributed to undernutrition. Increased levels of regular stomach upsets and regular bowel emptying at irregular places have been found to be further consequences of open defecation. It is in the face of this that it is said that the diseases arising from open defecation are often cyclic in nature thereby compounding the already bad situation. This is so as people with regular bowel emptying or stomach upsets hardly are able to cover required distances to toilets.
In the circumstances, they resort to open defecation thereby proliferating the diseases. Some researchers have also discovered that open defecation could lead to increased vulnerability to violence such as verbal, physical and sexual. This is explainable due to the tension in people when they are pressed and there is a disruption of the passage to defecation by other human beings, either due to queuing or distraction by others. We can also not underestimate impact on our environment as it introduces toxins and bacteria into the ecosystem. This equally affects other animals. In the face of all these impacts on our health and environment, it is compelling, therefore, that we must urgently and aggressively address the factors incubating the practice of open defecation. The overall cost of treating all these diseases is better imagined. We can convert the cost to productive use. The foregoing presumably underscores the signing and introduction of Executive Order No. 9. However, while the order sets out the framework, it does not pretend to have the solutions to the challenge. It is in this context that we intend to fill the gap by suggesting some solutions in a manner not exhaustive. In the first instance, it is gladdening that the Executive Order appreciates that charity begins at home by requiring all public facilities to put in place toilet and sanitation facilities. Undoubtedly this is the starting point. To the best of my recollection and experience, there is hardly any public building with functional and hygienic toilets, particularly for the public. Even the toilets meant for the staff are often deplorable. They all practically lack water. Without water, the journey towards eradicating the practice of open defecation has not started. A recent media report on the deplorable state of the toilet facilities at the Federal Secretariat, Abuja, is a good case in point. (https://freedomonline.com.ng/abuja-federal-secretariat-stinking-unbearable-uncomfortable). Again, although it is joyful that the President declared a state of emergency in the provision of water, without being pessimistic, this is not the first time that such a pronouncement has been made, we need to ensure that it is not mere rhetoric or a political statement by ensuring that it happens. Even if it cannot realistically be done all over the country, we must start in instalment with public buildings.
Secondly, as suggested in the executive order and having been tested in Lagos State during my time as the Commissioner for Environment, all commercial outlets must be made to make provision for public toilets, particularly petrol filling stations, eateries, hotels, entertainment centres, garages, etc. Associated with this is equally the compulsory provision for sanitation facilities in all future development. This concerns more the agencies in charge of physical and town planning. Relevant physical and town planning laws must be amended to provide for this, where such features are lacking in town planning laws. The executive order recognizes this also and it is already tested in Lagos State, hence it should not be rocket science implementing it elsewhere in the country. As further recognized in Executive Order 9, states have a significant role to play in the steps toward the elimination of open defecation, in terms of legislation, physical intervention, advocacy and enforcement.
I am aware that, in Lagos State, the practice of open defecation is already legislated against and criminalized. In this regard, Section 5 (1) of the Public Health Law, 2015, is apt. Similar provision exists in Section 9 (1) E of the Environmental Sanitation law of Lagos State, 2015. States that have not legislated in line with the executive order should be encouraged to urgently take steps in legislating against the practice. The various state governments must urgently embark on the aggressive construction of public toilets in strategic parts of their states. This, ordinarily, should be the business of the local governments.
Of immense interest also are local government councils that are constitutionally in charge of the garages, possibly in conjunction with the transport unions, to commence the provision of public toilets in the various garages and strategic open spaces. The use of the open spaces for projects of this nature equally has the potential of curbing the tide of crime, as those are places where organized crimes are planned. It would equally serve as effective waste management mechanism. State and local governments are equally better placed than the Federal Government to carry out the desired campaigns against the practice at the local level. This is not to say that the National Orientation Agency and, by extension, the Federal Ministry of Information cannot complement these efforts. There is need for aggressive campaigns through the traditional institutions and community leaders towards eliminating the various barbaric practices militating against the use of toilet facilities. Similarly, we need to engage religious leaders to sermonise on the practice as people tend these days to be religious, albeit not godly, for reasons other than conviction. All the same, the potency of this tool in the elimination of open defecation can never be underestimated. Equally important is the role of citizens in this initiative, especially residents’ associations and community development associations. A combination of incentives and enforcement is required to ensure that these entities make adequate provisions for the toilet activities of their common staff like security personnel and other service providers.
Beyond all these is the question of aggressive enforcement of the law. I am aware that, in some states, the law is there but the enforcement is nonexistent or weak. Happily, Executive Order 9 recognizes this deficiency also and prescribes that all security agencies must take up the challenge. However, I must register again that charity begins at home. The present situation where enforcement agents themselves constitute a sizeable number of those who practice open defecation will be a major impediment. The truth is that, because they are mostly on the road, they are not favoured with any alternative than the open spaces. It is trite that “Nemo dat quod non habet,” our law enforcement personnel cannot give what they do not have. We must equip them with the right mentality, motivation and access to be relevant to the achievement of the goals of the Executive Order 9. One recalls sadly an expose about seven years ago by Channels Television on the appalling state of toilets at the Police College, Ikeja. This aspect is very crucial to address, as it is the fundamental basis of all the other efforts. Once they are morally incapable of enforcing the law, all other efforts will easily hit the rocks. Therefore, we need to provide toilets for them on the road so that they can have the guts to enforce the law.
Furthermore, the role of environmental sanitary officers must not be underestimated. They are the crop of enforcement officers basically trained for this purpose. However, at the various levels of government today, they are neglected, to the detriment of all. Now is the time to not only wake them up but also convert the excess capacity at all levels of government to these schemes. This makes enforcement much easier and civil.
Again, as noted at inception, there are cultural beliefs promoting the practice of open defecation. In curbing this, we need to first and foremost educate traditional leaders about the dangers inherent in this practice, how the practice is causing woes for them. In addition, complete reorientation of those involved is crucial as their behavioural pattern towards toilet system needs to be changed. Major campaign must be embarked upon generally to highlight the dangers and provide solutions. For example, the World Toilet Day could be used to launch the campaign. We must promote the use of toilet bags that are biodegradable, where there are still challenges with the provision of toilets. I understand that a sophisticated one has been developed by a Swedish company known as “peepoo bag.” This at the initial stage can be imported, pending the time we are able to locally devise similar one. Due to the magnitude of fund required, temporary usage of bucket toilets of different shapes can fill part of the void in the interim. Compost toilets can equally be promoted in the crusade towards eliminating open defecation practice. Incentives to build toilets by way of subsidy and concessions can further accelerate the realization of the goal of Executive Order 9.
I must not fail to mention these two critical issues. First, it is important to keep at the back of our minds that, for a country that has over 16 million housing deficit, it not surprising that Nigeria has such monumental incidence of open defecation. Genuine efforts must be made to address this problem. Secondly, we must also not forget the principle of catching them young by institutionalizing the campaign in all schools. Formation of clubs in schools must be encouraged in this regard. The further advantage is that the pupils assist not only in the education of their parents and the elderly ones in the community, they can also trigger their thoughts in devising further modern ways of providing toilet systems.
The most important solution is the political will, which seems to exist, at least, stemming from the executive order. The drive is, however, crucial as this is not the first time in the country we are witnessing this trigger. As opined by Mr. Zaid Jaji, the then UNICEF Chief of Water Sanitation and Hygiene, “more people have access to cell phones than toilets.” Why can’t we make same happen in terms of toilets? This in our view is not good enough.
Let me conclude that the more we care for the environment and fund same, the lesser the cost of clinical health to the nation. The multiplier effect of healthy citizens with longer lifespan and higher productivity is the gain we stand to reap from this venture. Let us take advantage of the initiative, not only to rebrand our nation but also save our citizens. A word, it is said, is enough for the wise.