Why open defecation might remain prevalent among women

Doosuur Iwambe

‘’I suffered from vagina yeast infection for a period of six months. It all started like a joke after I used a public toilet in this market where I come every day to trade. As a trader, you cannot avoid it because there are days one gets very pressed.

After conducting series of tests and taking all manner of antibiotic, I was finally healed from the infection. From that day, I vowed never to sit on a public toilet again, I will rather defecate in the open than use a public toilet.’’

That was the testimony of 35-year-old Mrs. Sarah Anayo, a trader at the Abuja Municipal Council (AMAC) Market located in Lugbe, a satellite town in the Federal Capital Territory.

Mrs. Anayo who gave a detailed account of how she contacted the infection said that immediately she finished using the toilet facility on that fateful day, she started experiencing a funny feeling.

‘’ I knew something was wrong with me immediately I finished using the facility on that day. However, I gave myself one week to be sure before I began my medical quest for a cure.

My husband was the great victim in all this because for fear of passing it to him, I would give him one excuse to another on why we should not have sex.

‘’ After I was cured, I bought a bucket where I poo and wee in whenever I am pressed. I rather defecate in the open than use a public toilet again,’’ Mrs. Anayo maintained.

Also, 17 –year-old Deborah Thomas, a student of Government Day Junior Secondary School, Lugbe told Daily Times that she prefers open defecation to using the school toilets.

According to her, the toilets serving the students are not enough and are usually messed up. ‘’The school toilets will never be an option for me.

My luck is that my school is not in the heart of the town so whenever I am pressed, I run to the bush behind my school,’’ she confessed.

The practice of open defecation is a global developmental and health issue facing developing nations.

This is an ancient practice where people excrete in bushes, rivers, lakes, streams and other open spaces outside the designated toilets.

This can occur deliberately due to unwholesome cultural practices, superstitions and personal unhygienic behaviours. It can also be as a result of unavailable or lack of access to modern toilet facilities.

A study by Coffey et al (2014) lamented the high rate and practice of open defecation in rural communities, which remains stubbornly widespread with several dire consequences affecting the human health and environment alike.

This barbaric practice kills babies and impedes the physical and cognitive development of surviving children.

It also has significant negative externalities and releases germs into the environment, which pose serious harm to both the rich and the poor in the society.

The practice of open defecation is made worst in rural communities in Nigeria where it is tied to the culture, values, tradition and norms of the people.

In some rural communities in Nigeria, people find delight in defecating openly in rivers and lakes where they have the source for drinking water, hence denying self of safe and clean water as well as sanitary environment.

Most rural communities use woods and bamboos to construct open toilets for both men and women.

These locally constructed toilets are often done without proper drainage system, as such, at the slightest rainfall, faeces flow into the rivers and the nearby surroundings, thus exposing the inhabitants of those communities to grave dangers.

This has continued unabated without recourse to the environmental and health hazards that will likely ensure as a result of this practice.

As Nigeria is struggling to meet up with the 2025 target of ending open defecation, it appears that the task may not be an easy one, as most women for fear of infection prefer to defecate in the open.

A visit at Sango Ojurin Market Ibadan, the Oyo state Capital revealed that most of the market women prefer to defecate in their buckets and empty in the toilet rather than use the toilet directly.

According to a 55 –year –old trader at the Market, poor state of the facilities in the market has forced her to go back to her old way of open defecation.

‘’The toilets were hurriedly cleaned today because the officials were informed of your visit. You cannot go close to that toilet on a normal day because it is always in a bad state.

‘’ For that reason, once I am not in my house, I always find a means of doing it outside.

Moreover, I do not have the money to start running from one hospital to another treating infection. As they always say, prevention is better than cure’’, she said.

Many other traders at the market that also shared their experiences with our reporter during a visit to the market said that even though they know the health implication of open defecation, they prefer it to using the market toilets.

Simply identified as mummy Obaluluwa, she said, ‘I bought a bucket specifically for that purpose. I always ensure that it is neat at all times. An individual builds the two blocks of toilets we have here today.

We are calling on the state government to build additional toilets for us. Maybe that will be able to serve the population we have in this market.’’

Open defecation: A threat to women’s safety, health – Doctors

According to Dr. Olushola Badmus of Asokoro General Hospital, Abuja, open defecation is an issue that can affect everyone, but women are often at a higher risk of experiencing violence and multiple health vulnerabilities.

He identified that women with poor sanitation facilities are more susceptible to hookworm infestation resulting in maternal anaemia, which in turn is directly associated to adverse pregnancy outcomes.

‘’Women with limited or no access to toilet predominantly suffered from diarrheal diseases, a leading cause of under nutrition among women during their reproductive age.

The interaction between disease and under nutrition can further uphold vicious cycle of worsening infection and deterioration of women’s health, particularly in pregnant women,’’ Badmus added.

Also, Dr. Osayemen Olaye of St. Theresa Medical Centre, Gwagwalada, Abuja, linked sickness like water borne diseases, vector borne diseases and malnutrition in children to open defecation.

‘’Diarrhoea and other problems associated with the ingesting and exposure to human waste affect children under the age of five years the most since they are very susceptible to diseases.

This exposure is because most of open defecation happens next to waterways and rivers. In urban areas, this can include the drainage systems that are usually meant to traffic rainwater away from urban areas into natural waterways.

‘’Apart from water borne diseases, when the human waste collects into heaps, it attracts flies and other insects.

These flies then travel around the surrounding areas, carrying defecated matter and disease causing microbes, where they then land on food and drink that people go ahead and ingest unknowingly.

In such cases, the flies act as direct transmitters of diseases such as cholera,’’ he added.

A global survey has identified Nigeria as the second in the world among countries where open defecation is prevalent.

Only India ranked worse than Nigeria in the Water Sanitation and Hygiene (WASH NORM) survey conducted by the United Nations Children’s Fund (UNICEF).

The Nigerian Ministry of Water Resources and National Bureau of Statistics took part in the Nigerian survey, an official said.

Apart from Nigeria, five other African countries are among the worst 10 where open defecation is prevalent. They include Ethiopia (3rd), Niger (7th), Sudan (8th), Chad (9th) and Mozambique (10th).

Other countries in the worst 10 are Indonesia (4th), Pakistan (5th), and China (6th).

Speaking at an European Union workshop organized by the United Nations Children Fund (UNICEF) in conjunction with the Child Right Bureau (CRIB) of the Federal Ministry of Informational and Culture with the theme: “Clean Nigeria:

Use toilet” in Ibadan, Oyo state, Mr. Bioye Ogunjobi, WASH specialist said, 47 million Nigerians representing 24.4 per cent of the population still practice open defecation while 32 million people in the country still make use of unimproved latrine.

Bioye, who said the use of unimproved latrines is as bad as open defecation, added that only 13 out of the 774 local governments in Nigeria spread across four states, Jigawa, Bauchi, Benue and Cross River have been certified as open defecation free.

“In Benue, only one community has been certified ODF. There are communities that would have been certified open defecation free, but they still have problem with their market places and motor- Park therefore, they are yet to be certify. If a community is 99 per cent open defecation free, it cannot be certified until is 100 per cent,” he added.

He said that the federal government cannot successfully build toilets for all, but can only achieve this through public private partnership, adding that most Nigerians are yet to realise how deadly OD is to under 5 years children, the public and the society at large.

In his address at the workshop, head, CRIB Federal Ministry of Information, Olumide Osanyipeju said, recently, Nigerian government declared a state of emergency on WASH Nigeria and launched an ODF campaign strategy to jump-start the country’s journey towards ending open defecation.

Meanwhile, Nigeria loses over N455 billion of its Gross Domestic Product (GDP) annually due to poor sanitation and a third of that cost is as a result of open defecation, the United Nations Children’s Fund (UNICEF) has said.

According to the international body, Nigeria needs to add two million toilets every year between 2019 and 2025 to achieve the target of universal basic sanitation.

This figure from the north east according to UNICEF is out of the 47 million people that openly defecate in Nigeria.

The 2012 World Bank report showed that Nigeria loses N455 billion (US$ 3 billion) annually due to poor sanitation. This works out to US$ 20 per capita/year and constitutes 1.3 percent of Nigeria’s GDP.

According to the same report, open defecation alone costs Nigeria over US$ 1 billion a year. The market potential of sanitation in the country is huge. Nigeria could gain financially if the 47 million people that defecate in the open presently opt for a toilet. The demand for material and labour, on a conservative estimate, works out to N1250 billion (over US$ 8 billion).

How can Nigeria Improve?

According to experts, the biggest change factor is the availability of toilets. In many rural areas and slums, a large number of families share sanitary latrines or pit toilets. The Nigerian government should also offer incentives to sanitation entrepreneurs.

This will plant the seed for a growing business in latrines and drive down the cost of installation. Local governments should also be given budget allocations on a competitive basis.

They can be used to promote sanitation and make their local government areas open defecation-free.

This open defecation situation must be addressed if Nigeria is to truly develop.

The most recent effort is the “Make Nigeria Open Defecation Free” by 2025 national road map. Several other committees and policies exist to address the issue, but much more needs to be done.