Poor faecal waste disposal bad for ‘Big Four’ goal of healthy nation

A person produces an average of 120 grammes of faeces a day or five million kilogrammes by all Kenyans.

Challenges in safe management of faecal waste from toilet to treatment for recycle or reuse means a majority of it finds its way back in to the environment.

The latest impact report by the Water Services Regulatory Board (Wasreb) shows that only six million of the 40 million Kenyans are connected to the sewer network.

But these are present only in urban formal areas. Residents of rural areas and urban informal settlements have to rely on non-sewered systems, many with illegal disposal mechanisms, to address their daily needs.

Well-to do residential areas in the cities and the outskirts depend on septic tanks through organised associations as a means to keep sewers out.

EXISTING GUIDELINES

They argue that sewers open up areas for development regardless of existing guidelines from the Physical Planning Act.

Karen Hardy residents have been reported appealing to the Nairobi County government to support their rainwater harvesting efforts by draining an unnatural sewer swamp that had attracted marabou stork which transferred the waste to roofs.

Countrywide, floods following heavy rains resulted in submerging of pit latrines or destruction of other communal toilet facilities, putting in question the quality of ground water from unregulated boreholes where households source water for use.

Kenya Medical Research Institute (Kemri) and the Ministry of Health’s Division of Disease Surveillance and Response reported traces of the polio virus in samples from the sewer plant in Eastleigh, Nairobi.

That triggered a vaccination drive targeting 800,000 children.

CHOLERA

And since the beginning of this year, cholera has claimed more than 70 lives in six counties. Curiously, the cases proved that even if one is connected to the sewer system, has access to potable water and practises high standards of hygiene, if the next person can’t afford or access decent sanitation services, we are all at risk of suffering the consequences of poorly managed faecal waste.

National budget allocations to sanitation are spread across ministries including Health, Environment and Forestry, and Water and Sanitation.

Notably, there is no budget line for sanitation and allocations are collectively well below the 0.5 per cent of GDP-to-sanitation Ngor Declaration (2015) target.

Although sanitation now has a home ministry, in line with recent executive orders, a lot more needs to be done to ensure it does not remain clouded by interventions that focus on water and hygiene.

A breakdown of itemised budgets drawn from the National Budget must be clear on allocations to preventive health aimed at fighting communicable diseases related to sanitation.

CURATIVE SERVICES

The ‘Health Sector Working Report 2018/9-2020/1’ notes that “public spending is skewed towards high-end curative services, which is both inefficient and inequitable”.

This, in itself, is the bane of the problem as we work to achieve universal health coverage.

Unsafe sanitation is the leading cause of diarrhoeal disease and stunting in children under five while 17 per cent of workplace deaths are due to disease transmission with global productivity loss of $260 billion and school absences blamed on lack of access to a good toilet.

To eke out a living and to feed the ever-growing demand for greens and fruits in an urban setting, subsistence and entrepreneurial small-scale farmers are tempted to use of raw faecal waste as fertiliser.

PERISHABLE GOODS

Presence of E.coli in perishable goods on Kenyan tables across the socio-economic divide is a frequently highlighted phenomenon. Inflamed intestines as bodies fight off resulting infections means low uptake of needed nutrients.

The Nairobi Faecal Waste Flow Diagram (SFD) illustrates the flow of faecal waste – from the household to treatment site – on a city-wide scale.

Not all the faecal waste in the sewer system makes it to the treatment plants and, worryingly, well over half of waste from non-sewered systems is unaccounted-for.

Ensuring budgetary allocations that chip away at the problem and designing or supporting programmes in urban sanitation will ensure we are well on our way to a healthy and nutrition-secure nation.

Ms Juma is a communications and policy officer, African Population and Health Research Center. [email protected].