Ending open defecation in Lagos: Need for regurlatory, cultural, social and behavioral rejuvenation

By Lasisi Adedoyin K.S

“According to World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) Joint Monitoring Program (JMP) 2021 reports, 494 million people practice open defecation”. Most (92%) of these people lived in rural areas and nearly half lived in sub-Saharan Africa. Like other sub-Saharan African countries, Nigeria is slipping with the problem of open defecation. According to findings from the 2021 WASH NORM report, approximately 48 million Nigerians still engage in open defecation, and only 8% of the population practice clean handwashing. Sometimes in 2019, Nigeria became the number one open defecation nation globally.

By 2025, it is estimated that 56 million people will be engaged in open defecation in Nigeria if urgent action is not taken. This means a total of 102 million people or 20 million households should have access to a toilet and use it. Besides, sanitation facilities have to be provided to numerous institutions such as schools, health centers, market centers, motor parks, highway eateries, jetties, and religious places so as not to have any open defecation around these places. The adverse impact of open defecation is now well documented. According to a World Bank Report (2012), around 122,000 Nigerians including 87,000 children under 5 die each year from diarrhea; nearly 90% is directly attributed to water, sanitation, and hygiene. A comprehensive review of 21 studies, covering several countries found a 36% reduction in diarrhoeal morbidity due to improved sanitation.

According to the NDHS (2013), 37% of Nigerian children, under 5 were stunted (height for age), 18% wasted (weight for height), and 29% underweight (weight for age). According to the same study, while the percentage of stunted children declined between 2003 and 2013, there was an increase in the percentage of wasted and under-weight children. Ironically, the issue of open defecation is now a predominantly problem in major cities in Nigeria. For Lagos, the commercial, industrial, and social nerve center of the county, open defecation is practiced without fear. Very common in Lagos, you will see men, women, adults, and children openly squat and defecate openly without fear of being arrested or questioned. The practices have become so familiar that will make more than three or sometimes five men on a line defecating openly as if it’s an Olympic competition. For Lagos, open defecation is not a rural problem but an embarrassing socio-cultural and institutional problem that needs to be fixed urgently.

Like many urban areas around the world Lagos is no exception, open defecation is a pressing issue like a plague ravaging the inner city values and aesthetics. The sight and smell of feces on the streets is not only unsightly and offensive, but it also poses serious health risks to the population. Aside from the aesthetic values, the adverse impact of open defecation is now well documented. According to a World Bank Report (2012), around 122,000 Nigerians including 87,000 children under 5 die each year from diarrhea; nearly 90% is directly attributed to water, sanitation, and hygiene. A comprehensive review of 21 studies, covering several countries found a 36% reduction in diarrhoeal morbidity due to improved sanitation.

Also, report by the National Demographic and Health Survey (NDHS) (2013), 37% of Nigerian children, under 5 were stunted (height for age), 18% wasted (weight for height), and 29% underweight (weight for age). According to the same study, while the percentage of stunted children declined between 2003 and 2013, there was an increase in the percentage of wasted and under-weight children. Studies have shown that a large part of the malnutrition burden owes to the unhygienic environment in which the children grow up. The lack of proper sanitation facilities and the prevalence of open defecation contribute to the spread of diseases such as cholera and diarrhea, which can be life-threatening, especially for children.

Why is open defecation prevalent in urban areas in sub-Saharan Africa, such as Lagos?

Like Lagos, like many other cities in the world. There are not enough toilets to go around. The U.S. has eight public toilets per 100,000 people, tied with the Netherlands, Poland, Botswana, and Georgia. The country with the best record, Iceland, has 56 toilets per 100,000 people, according to QS Supplies data. For example. Philadelphia doesn’t have enough public bathrooms to go around. It has just four toilets per 100,000 people, according to 2021 data from U.K. bathroom supply company QS Supplies and from toilet-finding tool PeePlace. To compare, Madison, Wisconsin, has 35 toilets per 100,000 people, the highest ratio of any U.S. city. (https://www.smartcitiesdive.com/news/the-struggle-to-find-a-public toilet/628194/).

So how much is enough when it comes to the availability of toilets and how many toilets do we need per person?

To meet up with the toilet availability of a city, we need to consider if adequate toilet facilities are available for the infrastructure available within the city. For an office environment, it is recommended that 1 toilet and 1 washbasin for 1-5 people and 5 toilets and 5 washbasins for 76 to 100 people for all females working or mixed groups. However, 1 toilet and 1 urinal for 1-15 people for a male workforce environment. For public buildings such as shops and shopping centers with a retail area over 1,000m2, there should be One toilet per 500 male customers, plus one per every additional 1,000 male customers, or part thereof, One toilet per 500 female customers, plus one per every additional 200 female customers, or part thereof, Two urinals for up to 500 male customers, plus one for every additional 500 male customers, or part thereof, One washbasin for one male toilet, plus one for every five urinals, One washbasin for one female toilet, plus one for every two extra female toilets.

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Also, for school or educational facilities, the minimum number of school toilets you will be expected to provide depends on the age and schooling level of the pupils. For Nurseries (Pupils Aged 3-5): There should be one toilet per 10 pupils or part thereof, but no less than four, There should be one washbasin for every toilet and There should be one deep sink, bath, or shower per 40 pupils. For Primary Schools (Pupils Aged 4-11): There should be one toilet per 10 pupils aged under five years, and one per 15 pupils aged over five years, or part thereof. No more than 2/3rds of boys’ appliances should be urinals and There should be one washbasin for every toilet and urinal, which they should be fitted close to. For Secondary Schools (Pupils Aged 11+): For boys’ washroom facilities, there should be one toilet and a urinal for every 20 pupils, or part thereof. No more than 2/3rds of their appliances should be urinals, For girls’ washroom facilities, there should be one toilet for every 20 pupils, or part thereof and There should be one washbasin for every toilet or urinal, up to three appliances. Where there are more than three appliances, there should be two washbasins. It must be important to note that there should be separate staff toilets and facilities according to the regulations set out for office buildings and other workplaces, though facilities for disabled staff members may be shared with pupils. Where pupils are aged eight or over, changing rooms and sanitary facilities for PE staff should be in addition to and separate from the facilities provided for pupils.

For a public building where most toilet use will be during intervals, or after a certain number of hours (such as stadiums, concert halls, theatres, or cinemas), you should provide Two toilets for up to 250 male visitors, plus one more for every additional 250 male visitors, or part thereof, two toilets for up to 20 female visitors, plus one more for every additional 20 female visitors, up to 500 female visitors in total. Once this number has been reached, there should be an extra toilet provided for every further 25 female visitors, or part thereof, two urinals for up to 50 male visitors, plus one more for every additional 50 male visitors, or part thereof, one washbasin per toilet for male visitors and in addition, one urinal for every five urinals, or part thereof, One washbasin per toilet for female visitors, plus one for every two additional toilets for female visitors, or part thereof.

There are also minimum numbers of sanitary conveniences that must be provided for public buildings where most use does not depend on an interval, such as libraries, museums, and exhibition centers: there should be one toilet provided per every 250 male visitors, plus one for every additional 500 male visitors, or part thereof. Male toilet provision should be half of the female visitor provision where urinals are not used, there should be two toilets provided for up to 40 female visitors, three toilets for up to 70 female visitors, four toilets for up to 100 female visitors, and one extra provided for every 50 female visitors after this, or part thereof, there should be one urinal for every 50 male visitors, up to 100 male visitors in total, and then one more urinal for every additional 100 male visitors after this, or part thereof, There should be one washbasin for every male toilet provided, plus one more for every five urinals, or part thereof, There should be one washbasin for every female toilet provided, plus one more for every two more toilets provided, or part thereof.

Why availability is a major problem for most cities. However, there are factors contributing to open defecation in Lagos. Culture plays a significant role in shaping our behaviors, including the practice of open defecation. In some communities, open defecation has been ingrained in cultural norms and practices for generations. This could be due to a lack of awareness about the health risks associated with it, or the absence of access to proper sanitation facilities. Changing these deeply rooted cultural behaviors requires a comprehensive understanding of the underlying beliefs and values that drive them. Also, religion and belief systems influence attitudes towards open defecation. In some cases, religious rituals might involve defecating in open spaces, which can make it challenging to address the issue solely from a hygiene perspective. Sensitizing religious leaders and promoting dialogue between religious communities and sanitation advocates can help bridge the gap between cultural practices and the need for improved sanitation.

To bring about lasting change, it is crucial to communicate the importance of proper sanitation and hygiene practices effectively. Behavior change communication campaigns can use a variety of creative and relatable messaging to capture people’s attention and inspire them to adopt new behaviors.
By addressing the cultural, social, and behavioral aspects of open defecation, it is possible to rejuvenate attitudes and practices surrounding sanitation in Lagos. With concerted efforts and a sprinkle of humor, we can turn the tide and create a cleaner and healthier environment for all. For example, instead of simply telling people they should stop open defecation, we can emphasize the health risks associated with it. We can highlight the fact that open defecation contributes to the spread of diseases such as cholera and diarrhea. It’s also important to make the messaging relatable and easily understood. Let’s face it, nobody wants to read a boring pamphlet with complicated jargon. We need to communicate in a way that is simple, clear, and engaging. We can even throw in a few jokes to lighten the mood.

Education alone is not enough to end open defecation. We must also ensure that everyone has access to proper sanitation facilities. We need to prioritize the construction of toilet facilities that are easily accessible and affordable for all. This includes public toilets in crowded areas, schools, and marketplaces, as well as ensuring that every household has access to a private toilet.

But it’s not just about building more toilets; we also need to focus on upgrading existing facilities. The average elite in Lagos will not use the available toilet. This means we need to improve the condition of the available toilets. Also, most public toilets in Lagos are built where “area boys” socialize. This makes the use difficult for an average Lagosian who is fearful of the boys.

In conclusion, ending open defecation in Lagos requires a multi-faceted approach that encompasses public health campaigns, enhanced sanitation infrastructure, collaboration with stakeholders, and ongoing monitoring and evaluation. By engaging communities, implementing effective messaging, and providing equitable access to sanitation facilities, we can work towards creating a healthier and more hygienic Lagos for all. By implementing effective behavior change strategies, promoting hygiene education, improving sanitation infrastructure, and fostering community engagement, we can make significant progress toward ending open defecation in Lagos. It is only through collective efforts, collaboration, and sustained commitment that we can create a cleaner, healthier, and more sustainable future for the residents of Lagos.

Together, we can achieve a transformative shit and ensure that every individual has access to safe and dignified sanitation facilities. If Nigeria has to be open-defecation-free by 2025, 102 million additional people have to have access to a latrine by 2025. If SDG 6, target 6.2 is to achieve by 2030 access to adequate and equitable sanitation and hygiene for all and end open defecation; paying special attention to the needs of women, girls, and those in vulnerable situations. SDG 6.2 indicator should not just be another statistical variable in Nigeria’s statistical booklet.

Lasisi Adedoyin K.S Environment and Safety Expert, Coordinator of Eko Enviro Talk TV