WaterAid: Advocating Universal Access to Sanitation

Abimbola Akosile examines the vital highlights and recommendations contained in a new 2016 report on sanitation titled Overflowing Cities: The State of the World Toilets which was launched recently by WaterAid to mark the World Toilet Day on November 19, with a related release issued in Abuja by WaterAid Nigeria

WaterAid’s Overflowing Cities: The State of the World Toilets report looks at the problem of urban sanitation and the health threats to the world, as the United Nations (UN) predicts that by 2050 two-thirds of the global population will live in towns and cities.
The 2016 global theme for World Toilet Day (celebrated on November 19) highlights the fact that improved sanitation impacts not only health but livelihoods too, and has the potential to transform societies and economies by amongst other things, creating new green jobs and a healthier, more sustainable future.

WaterAid’s State of the World’s Toilet 2016 report also focuses on some of the jobs that are created when the challenge is addressed head-on. Universal access to water, sanitation and hygiene services would significantly contribute to growth, through greater productivity gained from less time wasted accessing water and sanitation, as well as reduced health care and mortality costs.

Other Nations
Among the report’s other findings, India, the world’s fastest growing economy, ranks top for having the greatest number of urbanites living without a safe, private toilet – 157 million. It is also a world leader in having the most urban dwellers practising open defecation – 41 million.
War-ravaged South Sudan, the world’s newest nation, is the worst country in the world for urban sanitation by percentage; 84 per cent of urbanites have no access to a toilet and every other urban-dweller there practises open defecation.

Fast-growing China is making the most progress in reaching its urban population with sanitation. It’s managed to build toilets faster than the pace of new arrivals, reaching 329 million people since 2000, and outpacing population growth by 9 million.

Focus on Nigeria
The report highlights the challenges facing 700 million urban dwellers around the world living without basic sanitation, 58 million of whom are in Nigeria. According to WaterAid, the problem is so big that 13.5 million people living in Nigeria’s towns and cities have no choice but to defecate in the open using roadsides, railway tracks and even plastic bags dubbed ‘flying toilets’.

Nigeria also ranks top in the countries falling furthest behind in reaching people with urban sanitation. For every urban dweller reached with sanitation since 2000, two were added to the number living without, an increase of 31 million people in the past 15 years.

Nigeria too has a huge population and extremely rapid rural-urban migration; however, economic development and urban planning have not kept pace with the sheer volumes of people arriving – and being born – every day in its towns and cities.

A World Health Organisation (WHO) report reveals that in Nigeria almost a third (29 per cent) of hospitals and clinics do not have access to clean water and the same percentage do not have safe toilets while one in six (16 per cent) do not have anywhere to wash hands with soap. In Nigeria one woman in every 23 will on average lose a baby to infection during her lifetime; compared to one in 7,518 in the UK.

When health workers have access to improved WASH facilities, they are able to carry out their jobs more effectively, protect themselves from infections and transmission of diseases and save lives of mothers and their newborns.

Local Assessment
According to WaterAid’s recent assessment of WASH facilities in Primary Healthcare Centres (PHCs) conducted in its six focal states in Nigeria – Bauchi, Benue, Enugu, Ekiti, Jigawa and Plateau – 21.1 per cent of the facilities assessed did not have at least one toilet facility.
Also, none of them met the National Primary Health Care Development Agency (NPHCDA) minimum standard of separate toilet facilities for males and females, as well separate toilet facilities for staff and patients.

Only 27.6 per cent of the 242 PHCs assessed met NPHCDA minimum standard of access to a motorised borehole. Across the six states, only 49 (20.2 per cent) of the PHCs had handwashing facilities in toilet facilities. Handwashing facilities were observed in delivery rooms in only 133 (54.9 per cent) of the facilities assessed. The ward and consulting rooms had handwashing facilities in 64 (26.4 per cent) and 74 (30.5 per cent) of the facilities respectively, suggesting poor hygiene practices in the health centres.

Executive Call
WaterAid Nigeria Country Director, Dr. Michael Ojo, said: “For the first time in history, more than half of the world’s population are now living in towns and cities. By 2050, that’s expected to rise to two-thirds. But for many, particularly the poor, they’re arriving or being born in overcrowded and rapidly expanding slums which lack safe, private toilets and clean water sources.
“This World Toilet Day, we are calling on our leaders to deliver on their promises to meet the UN’s Global Goal 6 to bring water and sanitation to all, because everyone – no matter where they live – deserves affordable access to these life essentials.

Crucial Tips
To mark the recent World Toilet Day, WaterAid Nigeria has called on the Federal Government to keep its promise to deliver universal access to sanitation, according to a release issued in Abuja by WaterAid Nigeria Communications & Campaigns Manager, Oluseyi Abdulmalik.
The non-governmental watchdog made the call following the release of new analysis showing that Nigeria ranks third in the world and worst in sub-Saharan Africa for having the most urban-dwellers living without a safe, private toilet.

WaterAid is calling for everyone living in urban areas, including slums, to be reached with a toilet to ensure public health is protected; more money, better targeted and spent, from governments and donors on sanitation, clean water and hygiene for the urban poor

The organisation also called for coordination from all actors in the sanitation chain including governments, city planners, NGOs, the private sector, informal service providers and citizens; and for sanitation workers to be given the respect they deserve with stable employment, safety and decent pay. Without them healthy communities and cities are impossible.

It also enjoined the Nigerian Government to ensure that schools, healthcare facilities and birthing centres have safe toilets, clean running water and functional handwashing facilities, to reduce maternal, newborn and child deaths and strengthen children’s ability to attend school.
It also sought for WASH to be positioned as a crucial contributor to health and for policy makers and health sector stakeholders to become aware of the link and crucial role that sanitation plays in improving child survival rates and health outcomes

To the organisation there is need for the inclusion of water, sanitation and hygiene into health plans, policies and programming and especially in plans to address under-nutrition and acute malnutrition.

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