Abuja, Nigeria – To mark World Toilet Day on November 19, WaterAid Nigeria is calling on its government to keep its promise to deliver universal access to sanitation, following the release of new analysis showing it ranks third in the world and worst in Sub-Saharan Africa for having the most urban-dwellers living without a safe, private toilet.

WaterAid’s Overflowing Cities: The State of the World Toilets report looks at the problem of urban sanitation and the health threats to our world, as the UN predicts by 2050 two-thirds of the global population will live in towns and cities. Nigeria too has a huge population and extremely rapid rural–urban migration; however, economic development and urban planning have not kept pace with the sheer volumes of people arriving – and being born – every day in its towns and cities.  To read the full ‘Overflowing Cities: The State of the World Toilets’ 2016 report click here

The report highlights the challenges facing 700 million urban dwellers around the world living without basic sanitation, 58 million of whom are in Nigeria. The problem is so big that 13.5 million people living in Nigeria’s towns and cities have no choice but to defecate in the open using roadsides, railway tracks and even plastic bags dubbed ‘flying toilets’. Nigeria also ranks top in the countries falling furthest behind in reaching people with urban sanitation. For every urban dweller reached with sanitation since 2000, two were added to the number living without, an increase of 31 million people in the past 15 years.

This year’s global theme for World Toilet Day highlights the fact that improved sanitation impacts not only health but livelihoods too, and has the potential to transform societies and economies by amongst other things, creating new green jobs and a healthier, more sustainable future.

Current evidence shows that working days lost to poor sanitation costs the global economy approximately $4 billion per year. Loss of productivity due to illnesses caused by lack of sanitation and poor hygiene practices is estimated to cost many countries up to 5% of GDP. A lack of access to sanitation cost the global economy US$222.9 billion in 2015, up from US$182.5 billion in 2010, a rise of 22% in just five years.

Sanitation creates jobs and prosperity, directly and indirectly. There is a potential total market of more than US$2.6 billion in sanitation and by increasing access to sanitation, through stimulating need, via sanitation marketing, and responding to existing unmet needs, untapped business opportunities open up. WaterAid’s State of the World’s Toilet 2016 report also focusses on some of the jobs that are created when the challenge is addressed head-on.

Universal access to water, sanitation and hygiene services would significantly contribute to growth, through greater productivity gained from less time wasted accessing water and sanitation, as well as reduced health care and mortality costs. An investment in improving access to safe water, sanitation and hygiene is probably the most effective investment Nigeria can make to grow its economy and better the lives of its people.

The high population density of urban areas means that diseases spread fast in the absence of good sanitation. One child dies every two minutes from diarrhoeal diseases caused by dirty water, poor sanitation and hygiene. Globally 159 million children under five have their physical and cognitive development stunted; many of such cases are caused from repeated bouts of diarrhoea attributed to dirty water, poor sanitation and lack of hygiene.

Water, sanitation and hygiene are intricately linked and underpin human health. The lack of access to safe water, basic sanitation and hygiene contributes to high mortality and morbidity rates especially amongst children, often leaving a lifetime legacy of disease and poverty.

Good sanitation is the bedrock of public health. Where poor sanitation exists, improvements in health and nutrition aren’t sustainable and children are repeatedly exposed to and at considerable risk of harm throughout their childhood. Diarrhoea caused by dirty water, and poor sanitation and hygiene is the second largest killer of children under five with an estimated 11 children in every 1,000 dying of diarrhoeal illnesses each year in Nigeria. Repeated cases of diarrhoea account for approximately 50% of all cases of undernutrition in children under five years of age, which in turn can lead to, severe wasting, pneumonia, and stunting.

‘Healthy Start’, is WaterAid’s campaign on improving child health and survival outcomes through improved access to safe water, adequate sanitation and hygiene. It is the global advocacy priority of our next strategic period, 2015 – 2020. The goal for Healthy Start is that decision leaders and policy makers ensure that survival rates and health outcomes are improved for children by integrating water, sanitation and hygiene within their policies, activities and rhetoric. In particular our aim is that the health sector joins with the water and sanitation sector in delivering water, sanitation and hygiene for all by 2030 as an essential requirement for increasing the numbers of children who have healthy childhoods, better prospects for healthy lives and for leaving poverty behind.

A World Health Organization report reveals that in Nigeria almost a third (29%) of hospitals and clinics do not have access to clean water and the same percentage do not have safe toilets while one in six (16%) do not have anywhere to wash hands with soap. In Nigeria one woman in every 23 will on average lose a baby to infection during her lifetime compared to one in 7,518 in the UK.
When health workers have access to improved WASH facilities, they are able to carry out their jobs more effectively, protect themselves from infections and transmission of diseases and save lives of mothers and their newborns.

According to our own recent assessment of WASH facilities in Primary Healthcare Centres (PHCs) conducted in our six focal states – Bauchi, Benue, Enugu, Ekiti, Jigawa and Plateau – 21.1% of the facilities assessed did not have at least one toilet facility and none met the National Primary Health Care Development Agency (NPHCDA) minimum standard of separate toilet facilities for males and females, as well separate toilet facilities for staff and patients. Only 27.6% of the 242 PHCs assessed met NPHCDA minimum standard of access to a motorised borehole. Across the six states, only 49 (20.2%) of the PHCs had handwashing facilities in toilet facilities. Handwashing facilities were observed in delivery rooms in only 133 (54.9%) of the facilities assessed. The ward and consulting rooms had handwashing facilities in 64 (26.4%) and 74 (30.5%) of the facilities respectively, suggesting poor hygiene practices in the health centres.

Within the Sustainable Development Goal committing to ensuring everyone has access to safe water, sanitation and hygiene by 2030, we want to see healthcare facilities prioritised – no new hospitals or clinics should be built without water and sanitation.

Among the other findings:
• India, the world’s fastest growing economy, ranks top for having the greatest number of urbanites living without a safe, private toilet— 157 million. It is also a world leader in having the most urban dwellers practising open defecation— 41 million.
• War-ravaged South Sudan, the world’s newest nation, is the worst country in the world for urban sanitation by percentage. 84% of urbanites have no access to a toilet and every other urban-dweller there practises open defecation.
• Fast-growing China is making the most progress in reaching its urban population with sanitation. It’s managed to build toilets faster than the pace of new arrivals, reaching 329 million people since 2000, and outpacing population growth by 9 million.

In Nigeria:
o Only 29% of the population has access to basic sanitation. Nigeria is one of a handful of countries around the world where access to basic sanitation is falling rather than rising.
o 25% practice open defecation.
o 31% lack access to improved water sources.
o Sub-Saharan Africa ranks lowest in the world for access to improved drinking water and sanitation. This is linked to the region’s under-five mortality rate which is one of the highest in the world.
o Around 45, 000 children under the age of five in Nigeria die from diseases caused by the nation’s poor levels of access to water, sanitation and hygiene.

A summary of findings on Nigeria in the report:
• Nigeria is third, after India and China, on a list of top 10 countries with the most urban dwellers without safe, private toilets (by numbers).
• Nigeria is ranked third on a list of countries with the most number of urban-dwellers practising open defecation and tenth on a list of countries with the most percentage of urban-dwellers practising open defecation.
• Nigeria is ranked number one in the list of countries falling furthest behind in reaching people with sanitation in urban areas.
• Between 2000 and 2015, there has been a significant increase in the number of urbanites without improved sanitation, (nearly 31.5 million people).

WaterAid Nigeria Country Director, Dr. Michael Ojo, said:
“For the first time in history, more than half of the world’s population are now living in towns and cities. By 2050, that’s expected to rise to two-thirds. But for many, particularly the poor, they’re arriving or being born in overcrowded and rapidly expanding slums which lack safe, private toilets and clean water sources. Diseases like cholera or Ebola can spread further and faster without sanitation and hygiene practices to block their path and an outbreak found in a slum can quickly become a city-wide, national or international epidemic. This World Toilet Day, we are calling on our leaders to deliver on their promises to meet the UN’s Global Goal 6 to bring water and sanitation to all, because everyone – no matter where they live – deserves affordable access to these life essentials.

“Our analysis shows just how many nations in the world are failing to give sanitation the political prioritisation and financing required – with Nigeria featuring strongly at the top of that list. The dirty issue of sanitation is too often neglected. But good sanitation is the bedrock of public health. The Federal Government recently launched the Partnership for Expanded Water Supply, Sanitation and Hygiene (PEWASH), a national multi-sectoral collaboration for the improvement of rural water supply, sanitation and hygiene. This is a great start tackling lack of access in rural areas, but with the recognition of this as a growing urban problem, there is a need to quickly focus on measures, with government leadership, to address this scourge in our towns and cities. Every town and city in the world needs to prioritise providing safe sanitation services to all the population in order to create a healthier, more sustainable future.”

This World Toilet Day, WaterAid is calling for:
• Everyone living in urban areas, including slums, to be reached with a toilet to ensure public health is protected
• More money, better targeted and spent, from governments and donors on sanitation, clean water and hygiene for the urban poor
• Coordination from all actors in the sanitation chain including governments, city planners, NGOs, the private sector, informal service providers and citizens
• Sanitation workers to be given the respect they deserve with stable employment, safety and decent pay. Without them healthy communities and cities are impossible.
• The Nigerian Government to ensure that schools, healthcare facilities and birthing centres have safe toilets, clean running water and functional handwashing facilities, to reduce maternal, newborn and child deaths and strengthen children’s ability to attend school.
• WASH to be positioned as a crucial contributor to health and for policy makers and health sector stakeholders to become aware of the link and crucial role that sanitation plays in improving child survival rates and health outcomes
• The inclusion of water, sanitation and hygiene into health plans, policies and programming and especially in plans to address under-nutrition and acute malnutrition.

For more information or to arrange interviews please contact:
• Oluseyi Abdulmalik, WaterAid Nigeria Communications & Campaigns Manager, on OluseyiAbdulmalik@wateraid.org or +234 803 431 2391.

Also visit www.wateraid.org, www.wateraid.org/nigeria; follow @WaterAidNigeria, @WaterAid or @WaterAidPress on Twitter, or visit us on Facebook at www.facebook.com/wateraid, www.facebook.com/wateraidnigeria


By Dotun Roy

DotunRoy.com is a development driven news website with the overall goal of amplifying, promoting and advocating for positive societal change through Sustainable Development advocacy in line with UN SDGs components such as education, environmental sustainability and Climate Change, Human Rights, health, finance, housing, good governance as well as security in Nigeria and across the world.

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