Tessy Igomu
It was peak traffic hour and the sun’s heat bore down in all its intensity that afternoon.
As motorists carefully navigated the deplorable road under the Mile 2 Bridge to escape the punishing gridlock on the Lagos-Badagry Expressway, they were greeted by the acrid smell of urine and faeces. With consternation and sadness, they held their breath to avoid inhaling the pungent odour.
Unsuccessfully, they also tried to divert their gaze from some young men that carefully positioned themselves by the bridge’s support beams, where they dutifully answered the call of nature. All around were unsightly droplets of excreta deposited by early callers to the waterfront.
For the many traders, street urchins, drivers and artisans that daily mill around this area, open defecation remains an accepted norm.
Open defecation is an old practice, but it still holds sway in this era of fast-paced technology and civilisation.
And to lend credence to the prevalence of this crude act wreaking havoc on society, Nigeria was recently listed among the top five open defecation countries in the world.
In the report, the country rose from its fifth position in 2003 to second place in 2015, behind India.
Speaking on the development, the Minister of Water Resources, Suleiman Adamu, said Nigeria was set to overtake India in open defecation.
“Nigeria will become the number one open defecation practising country when India becomes open defecation-free in October. Access to sanitation has been on the decline, from 30 per cent in 2010 to 28 per cent in 2015. Open defecation has been on the increase and there was not a single local government in Nigeria that was open defecation-free,” he said.
The minister stated that more than 48 million people still carried out open defecation, adding that it explained how Nigeria got its new position.
Adamu further said Nigeria was unable to attain the Millennium Development Goals (MDGs) targets for water supply and sanitation because of poor investments, low capacity and other challenges not limited to rural areas.
These factors were further buttressed by the 2018 findings of Brookings Institute, where the World Poverty Clock rated Nigeria as overtaking India as the country with the largest number of people living in extreme poverty, with an estimated 87 million people living on less than $1.90 per day.
With open defecation becoming an enshrined culture, the 2018 National Outcome Mapping Report showed that more than 47 million Nigerians defecated in the open, while the country lost N455 billion (US$1.3b) annually due to poor sanitation. The losses were primarily pegged on premature deaths, health care costs, and lost productivity.
Eliminating the practise in Nigeria, the United Nations Children’s Fund (UNICEF) estimated, would cost about N95 billion annually. It also noted that Nigeria could achieve economic gains as high as N359.1 billion ($1.026 billion) annually from the N455 billion it loses due to lack of sanitation.
As sordid as open defecation seems, it is not limited to rural communities alone, because people are steeped in the practice in several slums tucked in urban areas across the country.
For a city like Lagos, the act thrives and is decimating laudable projects meant to add aesthetics to the environment. Despite the inherent health hazards of having human faeces exposed to the elements, faeces litter public places such as motor parks, waterways, railways, filling stations, footpaths, highways, playgrounds, bridges and yards, among other places.
Ironically, to some people, open defecation has become an accepted norm. Baring it all to answer the call of nature, even when there are public toilets within reach, seems to have a special allure for some people. Though there seems to be no definite answer to why it still thrives, some have blamed it on poverty and lack of government support in providing toilet facilities. Most have argued, however, that in places where toilets are available, people still embrace the odd option.
For someone like Ugo Nweke, a street urchin by Mazamaza Bus Stop, open defecation is simply irresistible as the act itself gives a temporary feeling of ease and freedom.
Health implications
Experts maintain that, regardless of reasons given to justify the act, open defecation remains a ticking time bomb, as improper handling of human faeces poses serious health challenges to sources of water supply.
They noted that gravely endangered were the most vulnerable, women and children. A World Bank statistics and World Health Organisation (WHO) report warned that open defecation could lead to debilitating illnesses like cholera, typhoid, trachoma, diarrhoea, stomach upset, hepatitis and poor overall health.
Yet, the 2016/2017 Multiple Indicator Cluster Survey by UNICEF carried out in Nigeria noted that open defecation remains a challenge both in urban and rural areas. Also, the Nigeria Centre for Disease Control (NCDC), in its advisory campaign, said open defecation was one of the major causes of cholera in the country, especially during the rainy season.
Describing open defecation as alarming, a top UNICEF official, Zaid Jurji, lamented that one-third of Nigeria’s population still indulged in it. Worried that Nigeria might not even meet the global target of 2030 for ending the practice, Jurji said: “In fact, over 88 per cent of diarrhoea in children, the fastest killer of children under the age of five in Nigeria, is caused by open defecation.”
Apart from weakening children through frequent diarrhoea, exposure to human waste, experts warn, could make them susceptible to conditions such as stunting and malnutrition. They also said it increases the risk of polio infection, especially as the faecal-oral route remains an important transmission pathway.
This is even so as researches have shown that just a gram of faeces contains approximately 10 million viruses, one million bacteria and a thousand parasite cysts. It had also been revealed that children’s faeces, most likely to be handled more carelessly, contain more bacteria than adults’.
Cost of open defecation
In the 2018 NORM Report, 47 million Nigerians did not have toilets and another 75 million used unimproved toilet facilities. The report, jointly carried out by the National Bureau of Statistics, Federal Ministry of Water Resources and UNICEF, disclosed that Nigeria loses N455 billion (US$ 1.3b) annually due to poor sanitation. The losses were said to constitute 1 per cent of Nigeria’s GDP. UNICEF further blamed the losses on premature deaths, health care costs, reduced time and productivity.
Dr. Chisom Ede, a public health expert, noted that open defecation polluted the environment, water resources and air quality. She also blamed its prevalence on poor toilet and sanitation habits, adding that it had grave consequences for the country.
Kunle Olawale, another expert, said in a place like Lagos. where floods were prevalent, open defecation was a time bomb and an enabler for epidemics.
“When it rains in Lagos, it actually pours. With this scenario in mind, faeces will be washed into wells, streams and open pipes. This can cause soil-transmitted worm infections, which are only transmitted by eggs present in human faeces. The main species that infect people are the roundworm, whipworm and hookworms. It impairs the nutritional status of those infected, causing intestinal bleeding, loss of appetite, diarrhoea, dysentery, reduced absorption of micronutrients, poor intelligence quotient and, in extreme cases, death.”
Yet another expert, Mr. Chukwurah Henry, lamented that Nigeria has been perennially fighting infectious diseases, yet ignores simple and cheaper preventive measures.
While calling for massive awareness on the implications of poor toilet habits, he advocated the provision of clean toilets and water in public places to help reduce the act.
Nigeria, reports revealed, has a road map meant to make the country open defecation-free by 2025. But many have maintained that it does not just end with setting targets.
Global health agencies have stressed that Nigeria needs to launch a serious campaign against open defecation to attain Goal 6 of the United Nations Sustainable Development Goals by 2030.
And for Nigeria to be open defecation-free, the World Bank said about N2.88 trillion ($8.3 billion) needs to be invested.
And for Kunle Popoola, this can be achieved: “In the words of Bill Gates, during one of his visits to Nigeria, if the country considers her most valuable asset to be the human capital, nothing should be considered too much to invest in its development.”