The fight against open defecation: can it be won

By Amadu Kamil Sanah

Accra, March 28, GNA – Ghana has been ranked as second after Sudan in Africa, in open defecation with 19 per cent of the country’s population resorting to sanitation practices deemed the riskiest of all.

As a result, the country spends about $79 million and more yearly on the control of open defecation, which poses one of the greatest dangers to human health and has fatal consequences for the most vulnerable including children.

Open defecation is defined as the practice of attending natures call in the bush, at the beach, in drains and dump sites.

According to the Chief Officer at the Water, Sanitation and Hygiene, (WASH), Unit of the United Nations Children Fund (UNICEF), Ghana, David Duncan as at April 2016, indicates that three out of five Ghanaians practice open defecation and that in the last 25 years, Ghana made only one per cent progress at eliminating the practice of open defecation.

This means that Ghana could take 500 years to eliminate the practice of open defecation due to the slow pace at which strategies, laws and interventions are being implemented.

Causes Open defecation is increasingly becoming alarming in many parts of the country putting residents at the risk of sanitation related diseases such as cholera, diarrheoa and typhoid among others.

The lack of adequate and accessible toilet facilities in public schools, health facilities and household latrines are the major cause of open defecation in Ghana.

School children below the ages of 10 are often seen defecating around the premises of public institutions freely without any reprimand thereby giving a very bad smell to residents of the vicinity.

The increase in population without the correspondent increase in toilet facilities, the lackadaisical attitude of landlords to put up household toilet facilities coupled with the abuse of the few ones available by the ignorant people are some of the reasons believed to have caused some residents to resort to open defecation.

Impact on Ghana
The impact of open defecation on Ghana’s socio-economic development cannot be overemphasised.

Health experts have indicated that there is a direct correlation between open defecation and diseases such as dysentery, typhoid and cholera among others.

This is no doubt that in the wake of the outbreak of this diseases government spends huge sums of money in the procurement of medicines to manage the problem.

Apart from that, productivity sectors such as agriculture, industries, trade and the economy including all the government sectors are often affected leading to lower productivity.

The outbreak of diseases could also lead to many deaths as witnessed in the 2014 outbreak of cholera, which claimed more than 200 lives in the country.

In the last few years, UNICEF, with support from Canada and The Netherlands, have been working to educate and sensitise Ghanaians on the menace of open defecation.

These agencies are also providing sanitation facilities to more 300 schools and health facilities in the country.

Some artists in a platform are given the rare opportunity to express open defecation through art in various forms, which has helped to raise awareness whilst August 2016, UNICEF, in partnership with the Ministry of Local Government and Rural development, awarded three journalists who dedicated their stories to educating their audience on open defecation.

Possible solutions
The five-year 150 million- dollar Greater Accra Metropolitan Area (GAMA) Sanitation and Water Project funded by the World Bank through the International Development Agency (IDA) grant to provide water and sanitation services to urban communities within the catchment area must be expanded nationwide.

The project is currently being implemented in 11 Metropolitan and Municipal Assemblies in the GAMA and aimed at building 19,000 toilets.

It is also expected to build 250 school toilets for schools within the Greater Accra Metropolis and also applying some behavioral change communication strategies to work on the mind of the people regarding open defecation.

The toilets are to address the acute sanitation and water challenges confronting the urban communities, particularly the low income areas.

So far more than six household toilets have been built through the project, but the low uptake is due to the challenges of financing by the households.

The sanitation challenge cannot be solved by just building toilets. However, institutions such as Finneco Solutions and innovative toilet designs, Skyforks and Samalex could help solve the building of easy manage household toilets in Ghana.

The private sector has been identified as a key player in efforts to rid the country of filth and insanitary conditions.

Also, some private sector players have expressed the need for the revision of the decentralisation policy to address urban waste management problems and challenges.

But the institutions in the private sector are faced with challenges such as lack of access to financial credit and lack of government support.

Suggested remedies to curb the menace
First of all, the most important thing is to enforce existing sanitation laws and must be made mandatory that all compound houses and other abode in the country must have decent toilet facilities accessible not only to the landlords and family but to all tenants and occupants.

Secondly, there should be a strong political will by the government to improve sanitation in order to improve upon the lives of the citizenry.

A major national public campaign against open defecation and promotion of good sanitation practices should be there and public toilet facilities in deplorable states should be renovated and put into good shape to attract users.

New and modern public toilet facilities should be constructed and efforts must be taken to making public latrines free of charge and accessible at all times and most importantly, government should support and encourage environmental NGOs in their campaign to promote good sanitation.

The Way forward
It is very relevant to note that among the targets of the Sustainable Development Goals (SDGs) are to ensure the availability and sustainable management of water and sanitation for all.

Ghana’s efforts at achieving the SDGs on Sanitation and Water may be affected by the problem of open defecation.

The Community Led Total Sanitation (CLTS) module, which has been tried and tested and proven to be very effective and cost effective is an effective tool for curbing open defecation in the country particularly in northern Ghana.

Under the CLTS, communities are trained and equipped with indigenous technology available materials at the community level to build household latrines, educated to understand the health hazards of bad sanitation practices and to help to initiate their own methodology.

The Ministry of Local Government and Rural Development in collaboration with UNICEF in 2012 piloted the concept in five districts in the Upper East Region namely, the Bongo, Bawku, Garu, Kassena-Nankana West and Builsa Districts and made a significant impact with regard to sanitation.

Water borne diseases and other diseases associated with sanitation was drastically reduced in the piloted communities



Open Defecation, our collective responsibility

A GNA feature by Mohammed Abdul-Rashid

Accra, March 12, GNA – The record was forthright as it placed Ghana in the second position in Africa in Open Defecation (OD) with only 19 per cent of its total population resorting to good health and sanitation practices.

Northern Region was also ranked second in the practice of OD in Ghana.

This has triggered many attempts by writers and investigators to bring to bear the reasons behind this canker and a whole lot of reasons have been unearthed.

A survey conducted GNA recently indicated that, about 80 per cent of houses in Tamale Metropolis have no places of convenience.

It is an obvious fact that no one will like to leave his or her room to go to toilet in the bush right in the middle of the night, but circumstances have made it possible for people to take such risks.

Even though a number of politicians and about 30 NGOs in the Region are contributing massively toward sanitation and healthy life styles by building public toilets, the efforts are not enough to eradicate the delinquent behaviour.

The cost of patronising public toilets according to clients is so high that some of them are forced to engage in OD.

The survey revealed that the availability of open spaces, the forests and other vegetation cover makes the practice of OD to thrive.

Lack of awareness and poor attitudinal changes are also seen as the causes of the plague.

There was announcement of the position of the Region on the National Open Defecation Calendar in Tamale by Issahaku Alhassan, the Chief Director of the Regional Coordinating Council.

The survey indicated that seven out of 10 people questioned had no knowledge about the issues involved and the position of the Region on the calendar.

Problems of open defecation
Most of the people who are engaged in OD are not aware of the dangers involved in their action.

According to UNICEF one gram of faeces contains 10,000,000 viruses 1,000,000 bacteria and 1,000 parasite cysts.

It said faeces of children contain even more germs than adults.

In 2013 more than 340,000 children under five died from diarrhoea related diseases due to a lack of safe water, sanitation and basic hygiene – an average of almost 1,000 deaths per day.

In a media report the Minister of Tourism, Culture and Creative Arts, Mrs Catherine Afeku indicated that the practice of easing oneself in the open especially along the country’s beaches had contributed to the low patronage of tourism in the country.

‘You cannot aggressively bring people for tourism when you have open defecation at the beaches,’ she said.

If Ghanaians do not know about the kind of embarrassment their actions are bringing to Ghana internally and the dangers it imposes on their lives, how then, can they cooperate with the authorities to bring an end to the devastating social canker?

Way forward
Both educative measures and corporal punishments are necessary to help curb the situation.

The people must be constantly educated through music, giant billboards and other innovative means about the dangers of their actions.

Stringent measures should also be taken to prevent people from using forests and the open spaces as toilets.

To do this, individual and corporate organisation that own plots of lands in the towns should be made to fence them to prevent OD and until the authorities begin to take the bull by the horn, OD will continue to thrive with impunity.



Dear Valentine, Do You Have A Toilet?



My Dearest Valentine,
I love you so. It’s Valentine’s Day, and today is the day that I know you would propose to me, but… I am troubled that you don’t have a toilet.

I know what you say is true, that most people don’t have a toilet. Yes, I did listen when you told me that six out of every seven Ghanaians (20 million people!) don’t have a toilet for their household. And yes, I did listen when you told me that one in five don’t even use a toilet, but instead go to the bush or use a drain. But this is part of the reason why cholera is still such a problem in our country. Is this what you want for us?

So I ask myself, if I marry this wonderful, wonderful person, what would our life without our own toilet look like? Well, I would have to get up earlier each morning and queue for the public toilets. I do love you so. For you I can do this. But, what if the urge was too urgent and I couldn’t wait? I would need to find somewhere discrete by a drain or resort to a flying toilet in a black polythene bag… Hmmm. I do love you so. For you I can do this.

But what about when my family comes to stay? What about… my mother? Would you ask my mother to queue all hours of the day and night to use the public toilets? Ah, the public toilets… Oh my, she would say. The stench! The flies! The disease! The abomination! And we know that she’d be right. She would no sooner use those toilets than get half naked in public over a drain to ease herself. No… she would not come. Hmmm. But I do love you so. If I had to, I would choose you over my family.

What about the wonderful children that we would have? With us as parents, how could they not be perfect? But then I think of our wonderful children not having a toilet and having to wait in line at all hours with all sorts of people by the public toilet. And to expose our perfect children to such risks? I hear that over 3,600 children die every year from diarrhoea! Not even cholera. Just diarrhoea! And the risks if they are using public toilets or the bush or drains are more than twice higher than a household toilet. How could we put our children through that?

And if the urge came too strong to wait in the queue? They would have to find somewhere to hide and do it! What if they were followed? Oh the terrible things that could happen to them. And if they had to use the bush? What about snakes?? Snakes!!! Our perfect, young, vulnerable children… I love you so, but so would I love our children. I could not do that to them. No, no, no!

So, my love. You see that, as much as I do love you, I cannot marry someone that would not want and use a household toilet. I am sorry, but for the love of our children…

What’s that you say? You are happy to get our own toilet, for our own household? What joy! My Dearest, most Wonderful, will I marry you?

Yes!!!Happy Valentine’s Day!
Anonymous (UNICEF Ghana)



Open Defecation vs. Community Toilets: A Complicated Choice


By Meenakshi Dalal

A poster showing good hand washing practices outside a community toilet in Delhi. Photo Credit: USAID/India

She told us all to just forget it. I didn’t catch her name, I just watched her adjust the microphone and stand on tiptoes at the podium. Her grey hair peeked out from behind and she sounded frustrated.

Forget the security. It won’t make a difference. Forget the caretakers and the cleaning supplies. We don’t need those. We just want sewer lines in our communities. That’s enough now. We want to use a toilet in our home.

The other women in the audience clearly agreed given the loud burst of applause when she mentioned sewer lines. Instead, she has a community toilet; that or the choice of squatting somewhere out in the open. Choosing between defecating in the open or using a community toilet is layered with far more complexities than I’d understood before.

My colleagues and I from USAID/India were spending the day at a workshop organized by our partner, Centre for Urban and Regional Excellence (CURE). They’re in the early stages of a behavior change communication study that will help us understand why, even with access to community toilets, open defecation is still happening. There were about 100 people living in five slums across Delhi who had given up their day to tell us.

At the CURE Community Workshop on Behavior Change on December 20, 2016, women from five different Delhi slums discuss in small groups what influences their decision to use, or not use, a community toilet. Photo Credit: USAID/India

I’ve read the reports; I know the statistics. India has the highest rate of open defecation in the world. The Indian Government’s Swachh Bharat (Clean India) Mission is working to make the country open defecation free by October 2019. Open defecation can lead to life-threatening diseases. Women who defecate in the open are twice as likely to experience sexual violence. It’s alarming.

I sat with the women and some of the kids for lunch outside. I asked some fairly invasive questions about how, or if, they use the toilet in their slums.

They were candid. Veer, Neelam and Ruqyya did most of the talking, while other women huddled around and nodded, occasionally chiming in. They live in different slums but the experience sounded similar.

Veer always goes out in the open and she’s completely unashamed.

The men stand in front of the [community] toilet. They play games on top of the roof and then look down. They say things to us. You know, they’ll dress up as women. She demonstrated, pulling her dupatta all the way down over her face and shimmying. See? You can’t tell. I could be a man or a woman. You wouldn’t know. They dress up as women, they get in line with us, they might touch us. She demonstrated that too and it made me jump. Every few days someone is raped. On one side of the toilet is where we live and on the other side it’s jungle. They can pull us there.

I asked what would happen to the men and women if the women reported it. Their accounts were so much worse than the statistics I scan through in reports.

She’ll end up dead if we talk about a rape. What do you think? No, we just say she’s not feeling well for a couple days. Yes they say things to us every time. This is all during the day; we don’t go at night. The toilets are closed then anyway. We try to go in groups.

Neelam and Ruqyya are in their early 30s with small kids. Neelam said she goes two or three times a day. Each time it costs her one rupee. But there’s no soap and maybe one light. If she’s short on time and the lines are long, she and her children might just go in the open.

Ruqyya is luckier. She has a toilet in her home though most of her neighbors don’t. Her colony shares one community toilet with two other settlements. She said it was about 25,000 people using 42 toilets in questionable condition (that’s 595 people per toilet). If the toilets were open 24 hours per day (which they are not) each person would have less than two and a half minutes.

The next day at work, I counted how many times I used the restroom and did a little calculation based on what the women had said.

A workshop participant explains her community’s sanitation situation to her peers, USAID, NGOs, and other stakeholders. Photo Credit: USAID/India

Each time I went, I’d have to walk a bit, maybe 10 minutes depending on which slum I was in. I’d have to spend time in line and time walking back. There goes half an hour. It’d cost me one rupee each time. That’d add up. The chances of the toilet being clean would be low. If I had a kid, I’d have to figure out what to do with the child while I used the toilet. Even after all that, if I decided it was worth the trip and cost of using a dirty community toilet, it would almost be a given that a man loitering outside would say something vulgar to me or peep into the toilet while I crouched down to use it. The chances of my getting assaulted or raped, even during the day, would be high. Every single time.

If for every sip of water and bite of food I had to make the same decision as Veer, Neelam and Ruqyya…well, I’d choose open defecation too.

The women made their position clear: their solution is sewer lines; they want toilets in their homes. If community toilets are the immediate option then better maintenance and more security will encourage use. Understanding this information is the first and most crucial step to successfully ending open defecation. USAID and CURE will share what we learned with the local government, pointing out community-specific issues so that future interventions address what is most needed.

Two community members and their children complete an activity prioritizing what changes need to be made to their community toilets to encourage use. Photo Credit: USAID/India

There’s already a lot of USAID partner progress; I’ve seen the success USAID-supported partners have with this method. Water and Sanitation for the Urban Poor, in partnership with the local government, organized women’s groups that encouraged their communities to use toilets instead of fields. Because of these women, Visakhapatnam is among the 415 open defecation free cities in India. Another partner, Urban Management Centre, pushed for better toilet maintenance prompting the local government to triple sanitation worker salaries. It led to a more motivated cleaning staff and cleaner community toilets. This kind of advocacy works. It makes me confident that the results from this workshop will help the local government, CURE and USAID identify the right actions to take to help end open defecation. And to do so with safety and dignity for everyone involved.

Source: global waters

Arrest people practising open defecation – Environmental Officer







The Municipal Environmental Health Unit of the Savelugu/Nanton Municpal Assembly (S/NM) is to begin arresting residents, who practise open defaecation (OD) within the Municipality.

Mr Kombian Duut, S/NM Environmental Health Officer, who announced this, said it was to deter residents from practising OD to improve hygiene in the communities within the Municipality.

Mr Duut said already a resident was released on bail after being arrested for practising OD in the Municipality.

He was speaking at a forum organised by the Ghana Anti-Corruption Coalition (GACC) and Centre for Democratic Development-Ghana (CDD-Ghana) at Savelugu to discuss issues of health and sanitation as captured in the 2016 Open Defaecation free (ODF) League Table.

The forum, facilitated by the Savannah Integrated Rural Development Aid (SIRDA), formed part of the “I Am Aware” project being implemented by GACC and CDD-Ghana.

It was attended by officials from S/NM, residents and representatives of some civil society organisations.

The ‘I Am Aware’ project is an online platform where data on public service delivery in sectors including health, education, sanitation, water and security are published for all to access and use for evidence-based advocacy.

Mr Duut said OD was the major health problem in the Municipality as many houses did not have toilet facilities forcing residents to practice OD.

According to the 2016 ODF League Table, S/NM placed 15 in the Northern Region with 10 of its communities declared as ODF or having access to toilet facilities.

Mr Duut urged landlords to make provision for toilet facilities in their property to stop OD in the municipality.

Alhaji Mohammed Shaibu, S/NM Planning Officer urged residents to embrace the community-led total sanitation strategy to construct their own toilets to improve hygiene in their communities to avoid diseases.

Some community members, who took part in the discussions, appealed to S/NM to support households with subsidies to construct household toilets since they could not afford the cost of constructing the facility.

Others expressed need for sanitary inspectors to be deployed to communities to educate residents on OD as well as sanction those flouting rules on environmental sanitation.

Hajia Alima Sagito Saeed, Executive Director of SIRDA said efforts would be made to continue to mobilise residents to understand the issues as regards the I Am Aware project to promote accountability.



Volta chiefs join ODF campaign







Some chiefs in the Volta Region have joined the campaign against open defecation with the institution of fines and sanctions against sanitation offenders.

Last year, some sanitation offenders were fined plastic chairs and bags of cement for their communities, Mr Richard Ahiagbede, Volta Regional Director, Environmental Health and Sanitation told the Ghana News Ageny.

He said the chiefs had adopted the Community-led total Sanitation concept in helping to enforce sanitation laws in the communities.

Mr Ahiagbede said in view of that commitment and support, his outfit was targeting the declaration of 87 more communities as Open Defecation Free (ODF) in the year.

He said in 2016, 107 communities were declared ODF in 14 districts namely Ho Municipal, Kadjebi, Kpando, Akatsi South, Ketu North, Adaklu, Ho West, Hohoe, North Dayi, Ketu South, Akatsi North, South Dayi, Biakoye, and Keta.



‘Developed’ Ghana 2nd in open defecation – Yaw Nsarkoh jabs


Executive Vice President of Unilever Ghana& Nigeria, Yaw Nsarkoh has said the supposed development of Ghana is questionable.

In his view, Ghana is still underdeveloped since it has been ranked second after a Sudan in Africa for open defecation.

This damning statistics, the Unilever Ghana boss indicated means that, three out of every five Ghanaians are subject to this demeaning and insanitary condition.

Mr. Nsarkoh made this known when he took his turn at the monthly symposia of Achimota School dubbed: Achimota Speaks to mark its 90th anniversary celebrations at the Ghana Academy of Arts and Sciences in Accra.

Speaking on the theme: A nation divided…that all may be one , he quoted the Chief Officer at the Water, Sanitation and Hygiene (WASH) to corroborate his claim.

“WASH estimates that Ghana will take 500 years to eliminate the practice due to the slow pace at which strategies, laws and interventions are being implemented. I am being deliberately provocative; on sanitation as in other matters, we are a people divided” he stated.

Given this humiliating exposé, Mr. Nsarkoh said it is evident “we are an open defecation country (ODC).

“A pathetic outcome of the first order. I am being deliberately provocative; on sanitation as in other matters, we are a people divided. Some, the few, live in glamour; others, the many in fact, live in squalor” he added.

Yaw Nsarkoh called on all key stakeholders especially in the sanitation sector to nib this shameful development in the bud.

The monthly symposia is designed to share Achimotan thoughts on various aspects of Ghana’s national discourse. This is guided by the theme of the celebration to several fun and nostalgic activities that will serve as platforms to reunite long-lost peers, friends and family.



Over 30 NGO Fights Open Defecation In Northern Region

By: Alima Bawah-Tamale

Mion district tops others with the least percentage of residents who defecate in the open with Tamale metro at the bottom of the league table. The District league table (DLT) is a bi-annual Water and Sanitation (WASH) technical assessment and ranking of the performance of Metropolitan, Municipal and District Assemblies (MMDAs) in fighting open defecation. The assessment was conducted by the Environmental Health and Sanitation Directorate of the Ministry of Local Government and Rural Development.

With a target score of 100%, Mion district scored 73% and was first on the Table followed by Nanumba North with a score of 55%. Karaga, Zabzugu and Tatale-Sangule respectively are among the top five districts on the Table. Tamale Metro was last with a score of 10% indicating a greater percentage of its residents defecate in the open.

Sawla-Tuna-Kalba (20th), Kpandai (21st), Sagnarigu (22nd), Bole (23rd), North Gonja (24th) and Mamprugu Mogduri (25th) are among the underperforming districts where Open Defecation is highly practiced. According to the Regional Director of Environmental Health and Sanitation Rex Jakpa Mumuni, the main indicator of how districts performed is the percentage of certified ODF communities per each district. An ODF community is one with no visible faeces around and all households have access to and use latrines.

At the launch of the DLT yesterday at the regional coordinating council, Chief Coordinating Director Alhaji Issahaku Alhassan expressed his dismay at the abysmal performance of Tamale metro and others for doing very little to combat open defecation in their districts in spite of the huge budgetary allocations of the MMDAs and donor funds in the area of sanitation. He said this assessment was to create positive competition among MMDAs in improving the sanitation conditions in their areas.

According to him northern region has over 30 NGOs in WASH who are contributing to better the sanitation conditions of districts yet it leaves much to be desired. He therefore called for more effective measures by MMDAs to elevate the region from its current second position in Ghana as open defecation prone.

United Nations Children’s Fund (UNICEF) chief of field operations at the Tamale office, Madam Margret Gwarda urged the district directors to go beyond the attainment of their current status by sustaining and improving on it while encouraging underperforming districts to step up their efforts in the fight against open defecation.

The open defecation League Table is part of the strategies adopted by the Regional Coordinating Council and its development partners such as USAID, UNICEF, RING, amongst others to step up efforts of districts in addressing the practice of open defecation.

The next league table is expected to be unveiled by the end of June.