What counties should do to end open defecation
It is unfortunate that Kenya, a middle income economy, continues to engage in a conversation about open defecation.
The right to reasonable standards of sanitation is inked in Article 43(b) of the Constitution. However, in practice, the implementation is slow.
Counties have inadequate or non-existent budgets for sanitation and hygiene programmes.
Inadequate knowledge on the importance of using a latrine, nomadic lifestyles, cultural issues and topographic challenges in sinking a pit latrine are partly to blame for the current state of affairs.
The population census in 2019 revealed that 15 counties were responsible for 85 per cent of open defecation.
It further revealed that one in four people in 12 counties practices open defecation.
Turkana was listed as leading in open defecation together with Mandera, Garissa, Kilifi, Baringo, Samburu and Tana River counties.
Only Busia, Kitui and Siaya counties have achieved Open Defecation Free (ODF) status.
What lessons could the 44 counties grappling with open defecation emulate? What strategies can they adopt to exit the list of shame?
The annual National Sanitation Week under the theme ‘Good leadership in sanitation and hygiene is key to ending open defecation’ was marked from August 9.
The activities were designed to rally communities to end open defecation, focus on a clean environment and challenge county governments to prioritise sanitation and hygiene by allocating funds.
Whereas this was realised over the week, there is need for a shift in the mindset to meet the 2025 ODF country target.
Counties must follow the footsteps of those who succeeded where they failed.
Kitui, considered one of the largest counties with a population of 1.13 million people offers good lessons.
The county succeeded in ending open defecation three years ago. It’s strategy was simple; create fear, show open disgust and shame those who practice open defecation.
The county also allocated funds towards sanitation programmes between 2013-2017 that included sensitisation of school children and teachers.
The programme also incorporated government administration officers, village elders and dedicated Community Health Volunteers in community led activities, as well as discouraged dependency syndrome in construction of latrines.
It was a similar script in Siaya county. With a population of 993,183, Siaya people embraced the use of ‘community rovers’.
Their job was to conduct random checks and shame those practicing open defecation.
In addition, they introduced a Rapid Results Initiative programme, a non-monetary reward system.
This ensured constant follow-ups, engaged role models, organised review and stakeholder’s meetings as well as dismantled cultural barriers by offering alternatives.
One such barrier was to advise the community to construct two doors for one toilet. One door was reserved for the parents and the other for children.
Siaya also embraced a campaign dubbed “Bora Choo” which means “at least a toilet” to fast-track compliance.
This campaign mutated to “Choo Bora” meaning “a quality toilet” to sustain the open defecation free status it enjoys.
Achieving an Open Defecation Free status is not a walk in the park. A village is subjected to a rigorous process.
Officers check to ensure no human waste is visible in open spaces, which includes the floor of a latrine.
A latrine must have walls for privacy; the aperture should be covered to avoid contamination of food by flies and the floor must be easy to clean.
The next step requires Community Health Volunteers to inspect and divisional officers then verify the claim.
The report is forwarded to the county headquarters and an external team from a neighbouring county invited to certify.
Thereafter the Ministry of Health under the WASH hub authenticates the claim and a banner or bill board is mounted to celebrate the ODF status.
As the clock ticks towards 2025, there is need for an accelerated campaign. Counties must re-focus on sustainable sanitation solutions.
Hygiene and sanitation programmes must be institutionalised and funded. Communities should be educated on the link between poor sanitation, health and diseases. —The writer is the Director of Public Health at the Ministry of Health