Poor Sanitation and its consequence
By Mustapha Sesay
Poor sanitation which has always been associated with Africa, has significant negative effects on the national economy and that 49% of all reported sickness and injuries in Sierra Leone is related to poor sanitation. Lack of adequate sanitation is a major threat to the environment which includes the degradation of the urban environment by the indiscriminate disposal of solid and liquid waste and the pollution of fresh water and lakes by untreated human waste, the result being smaller, contaminated fish catches.
The cost of environmental damage includes discouragement of the tourist trade, reduced overseas markets and revenue for fish products, reduced production from fisheries and increased purchase costs for chemical and mechanical clean-up operations. The cause of this are all sanitation-related, either from poor lake water quality or poor hygiene during the catching process. In the 90s down to 2000, there were more government aided primary schools for students; of these schools, 44.5% had water supply
Many schools, particularly rural schools had no latrines at all and of those with latrines most did not have separate latrine facilities for girls and boys. Lack of latrines especially separate latrines for girls was identified as the worst school experience for girls. This illustrates that the issue of poor sanitation is one of the special conditions which prevent girls from fuller participation and achievement in schools and to an extent force them out of school.
Following the recent implementation of the policy for universal primary education, the ratio of pupils to latrines may now exceed and may encourage further drop out especially among adolescent girls. Morbidity figures available according to outpatient diagnoses shows that diarrhea, worm infections, eye infections and skin disease accounted for 25.5% of all outpatient visits to health, while malaria (another disease related to poor sanitation) accounted for further another 35.5% (i.e. a total of 59% of all outpatient visit are accounted for by poor sanitation). The level of nutritional stunting in the country is still among the worst rates of nutritional stunting in Africa and is partly attributed to the high incidence of diarrhea, an average of 5.2 episodes a year for children under fire. By the end of April, many people had been taken ill with a total of more deaths.
This gives a case fatality rate of 4.3%, causes identified for the diarrhea outbreaks included overcrowding, lack of sanitary excreta disposal facilities, high water-tables, lack of safe drinking water, poor food hygiene in markets (vendors and purchases), and inadequate solid waste disposal. Along with a higher incidence of diarrhea, slum dwellers in swampy areas suffer a greater incidence of malaria special gender needs. Women and girls are the caretakers of the home charged with the responsibility of cooking (86%) water collection (70%) and fire wood collection (73%) child care (62%) and (88%) care for the sick and elderly.
Women work an average of 15 hours each day. No comparative figure is available for men, but it is estimated to be significantly lower. While 70% to 80% of the agricultural labour force is female, only 79% of women cultivate their own land and only 30% have access to and control over the proceed, including the resources needed for sanitation services.
Twenty percent of formal sector employees are women and those women are mostly in the lowest percentage in terms of jobs. Sanitation affects men, women and children in different extents, but is generally worse for women simply because the problems of proximity for urination and defecation are especially acute for women and adolescent girls in urban areas and are heightened during menstruation. Further study and gender analysis are required to determine the needs of men, women, boys and girls and to determine the optimum course of strategy to involve the active participation of them all.
Raising the profile of sanitation, the national constitution states that it is the duty of every citizen in the country to create and protect a clear and healthy environment. The first step in the process of improving sanitation in the country was to gather all existing data on sanitation. Though there is a codify concept on sanitation, but how effective is that particular document and how many
Sierra Leoneans are knowledgeable of that concept. Although those at the apex of the political cadre are saying that it is the most comprehensive statement on sanitation ever written in the country that covers the overall situation in the country, both past and present, discusses the effects of poor sanitation and the reasons for its marginalization, and calls for an accelerated national sanitation programme, yet many would love to be fortunate to peruse it and au fait with every bit contained therein.
The improvement of sanitation is a highly political process targeting all elected officials in the country starting with the President, who according to his political manifesto many years back included sanitation as part of his top priorities, moving down to the village level. Apparently it should be the intention of government to reach the entire population by using a community based participatory approach, change the norms in regards to sanitation.
The new approach to improving sanitation I opine will build on the grass roots, local government councils and development committees to plan and maintain their own sanitation improvement activities and promote individuals action for change with the support of technocrats from all sectors including health, education and community development. The approach is based on the principles of empowering people to help themselves.
This process once in place will start with participatory information collection leading to action plans also developed in a participatory manner.
The plans will provide people with increased knowledge (education) and increased understanding (free discussion), building on the collective wisdom, strength and best practices in the community around them. In urban centres, pressure may need to be exerted on landlords and service providers to comply with minimum service standards. In rural areas, more emphasis may have to be placed on deserving positive image for promotion sanitation within the context of the local traditions and beliefs. At the same time specific efforts will be made to discourage negative taboos and beliefs.