Combating the deadly impact of open defecation

Date: 9th December 2019

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Stakeholders call for a change at the national level to realize the ambition of achieving SDG 6.2 by 2025

By Alain Tossounon

A local girl on her way back home from school. ©WSSCC/Alain Tossounon

LADJI, Benin – In Benin, basic sanitation and hygiene are still a luxury for many people living in both rural and urban areas where open defecation is commonplace.

The consequences of this practice for the health of residents are enormous, forcing them to pay a heavy price for health care.

And while the Government of Benin is committed to achieving the Sustainable Development Goal (SDG) Target 6 in the subsector that improves water – thanks to a record mobilization of several billion CFA francs, basic sanitation and hygiene are yet to benefit from the same investment.

Fatal health consequences

Tingnivou Nouvoessi, fish seller. ©WSSCC/Alain Tossounon

Ladji is located in the sixth district of Cotonou, the largest city in Benin. In this neighbourhood, access to toilets for every household remains a dream.

Not far from the paved road through the quartier Sainte Cécile, the path gets narrower and narrower. As we walk along it, skirting the puddles of water from recent rains, we find ourselves in a vast expanse of informal housing.

Among the domestic waste left on all sides and around the precarious homes jammed in against one another, children play along the narrow alleys strewn with leftover food and plastic bags. Nearby, others try as best as they can to clear a space in an informal landfill site to defecate under the benevolent gaze of their onlooking parents.

Here, one gets used to defecating in the open or in stretches of water. And without being asked, Mr Damien Missihoun, a neighbourhood resident, explains the children’s behaviour. “In Ladji, we have the problem of not having enough latrines. Here, people defecate into bags that they throw down anywhere, because they don’t know where to go.”

Honoré Nouvoessi, retired fisherman. ©WSSCC/Alain Tossounon

“When it happens that I need to go to the toilet at night, I don’t dare go out. I do my business in a bag that I put in a jar and I go out in the early hours of the morning to tip it into the lake,” explained Ms Marcelline Hounvo, a 40-year-old stall-holder at Dantokpa market, with a note of bitterness.

“This quartier is in a dreadful state,” said Mr Honoré Nouvoessi, a 70-year-old fisherman sitting outside his room door.

In this quartier, with many of the characteristics of a slum, people still live in communities with 10 to 15 families. Having a toilet for every home is simply a luxury.

Apart from the rare individual latrines, there are just three community latrines for the 100,000 residents of the quartier – and these are not always in operation in times of flooding.

Under these conditions, there is no option but for open defecation. The story of Ladji is all played out in the absence of an effective waste-collection system and a lack of access to toilets and to the adoption of good sanitation and hygiene practices.

The health consequences can be dramatic at times. “We very often get malaria attacks. Apart from that, we go to hospital for diarrhoea and sickness, as well as other illnesses,” said Mr Claude Dohougbo, a fisherman by trade who, with his sad face moistened by tears, told us that he had lost one of his eight children after chronic diarrhoea.

He is not the only one that has experienced tragedy. “I lost 13 children in succession, all when they were small. My children have lost 10 of their own children. I didn’t have the means to save them. Health care is too expensive. I couldn’t meet the costs,” sadly said Mr Nouvoessi.

These are people who rub shoulders with death and faeces-borne diseases on a daily basis. In Ladji, the peril of faeces-borne diseases is in every household, confirmed Dr Théophile Hounhouédo, a public health physician and executive director of the ‘New Life’ NGO responsible for a medical and social centre in the heart of the quartier.

But in Benin, unfortunately, Ladji is no isolated case.

Awareness remains low

Just like those living in the Ladji neighbourhood, others in various quartiers and villages scattered across Benin still practise open defecation.

In 2017, according to the Demographic Survey of Health in Benin (EDSB, in French), 87 percent of households in Benin still used sanitary facilities classified as unimproved and only 21 percent used shared toilets. More than one household in two (54%) did not use a toilet and only 20% of households used improved toilets.

Open defecation is still practised by 53% of the population of Benin, according to the WHO and UNICEF Joint Monitoring Programme (JMP).

While the availability of space complicates the situation in the Ladji informal settlement, urbanization has never been completed there. Dr Hounhouédo argues that the neighbourhood’s pervasive poverty is one of the causes of the problem.

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