Sh*t happens

Welcome back! In this post I aim to provide perspective on the issues relating to faecal contamination and management.  

Before we begin, it’s important to understand the reasons for faecal contaminated water across Africa. The basic yet controversial answer would be to blame citizens and development status. However, a more complex answer would question the dishonesty of ‘improved water sources and inadequate provisioning of proper management for faecal waste from the top-down level. Of course, we will be delving into the complex answer. 

‘Improved water sources’

First things first, we have to narrow down a definition of improved water sources. The WHO/UNICEF Joint Monitoring Programme (2017) report defined drinking water as ‘by the nature of their design and construction, have the potential to deliver safe water’ with three conditions: (1) accessible on premises, (2) water should be available when needed and (3) be free from contamination. I’ll admit, even writing the ‘so called’ classification for ‘improved water sources’ is difficult especially after reading Nayebare's study (2020) which revealed some shocking horrors. The study revealed that:

~55% of improved water sources comprising shallow hand dug wells and springs showed gross faecal contamination by E. coli.

~51% of on-site sanitation facilities are unimproved.

This study investigated water, sanitation and hygiene (WASH) conditions in a small town called Lukaya located within Central Uganda, East Africa. It highlights the fragility and vulnerability of on-site WASH facilities which coincides with the inadequacy of current monitoring and maintenance. Whilst other studies find that access to improved sources have improved over time across Sub-Saharan Africa, they have failed to assess the extent to which they have been ‘improved’ therefore ignoring the aspect of ‘safe water’ (Armah et al. 2018). This failure to legitimately improve water sources is reflected in figure 1 which represents a shockingly high share of the population across African countries lacking access to SAFE, ‘improved’ water sources. 

Figure 1: Share of population without access to an improved water source, 2020

Unfortunately it is difficult, as residents across different African countries are heavily reliant on both improved and unimproved water sources and so, the dishonest classification of improved water sources poses serious threats to human health and livelihoods (Mutono et al. 2020). Faecal contaminated water is highly linked to the transmission of diseases such as cholera, diarrhoea, dysentery. The rise in diarrhoeal morbidity is determined by poor hygiene including open defecation, unsafe disposal of faeces and wastewater as well as poor education and sourcing water from unsafe surface waters (Tumwine et al. 2002). Other related implications involve difficulties with paying medical costs, being less economically productive as well as children missing school. These negative social implications of faecal contaminated water ultimately lies in the hands of top-down authority due to the inadequate and unsafe sanitation systems, which continues to be a vicious cycle.