Wednesday, March 29, 2023

The issue of taking defecation seriously

Mantle (faeces) was the buzzword at Cresta President Hotel on Thursday as the Ministry of Health (MoH), and the Ministry of Local Government and Rural Development hosted a breakfast meeting to develop advocacy for Community Led Total Sanitation (CLTS).

Speaking at the meeting World Health Organization (WHO) representative to Botswana Dr Felicitas Zawaira said inadequate sanitation is a major cause of disease worldwide, adding that improving sanitation is known to have significant beneficial impact on health both in households and across communities.

Sanitation, which refers to the provision of facilities and services for the safe disposal of human urine and faeces, has been a major cause for concern in Botswana.

Open space defecation is still the order of the day for most poor and marginalised communities across the country. In the urban areas, taking a leak on the streets is no taboo either.

“Unsafe water and inadequate sanitation and hygiene are significant contributors to the 1, 8 million deaths caused by diarrhoea every year while millions more suffer from intestinal worms, bilharzia and trachoma,” Zawaira said.

He said lack of improved sanitation is holding back Millennium Development Goals (MDGs), including child and maternal health, nutrition and education, as well as affording dignity and empowerment especially to women and girls.

Water and sanitation are fundamental requirements for human health and development.

“Poor sanitation itself causes disease and contaminates water which in turn causes more diseases,” he said.

Zawaira attributed sanitation problems to among other things, limited and inequitably distributed resources, poverty, displacement, and generally poor prioritisation and planning.

“Many people affected by this are rural people,” he said.

Kgosi Mboma Diziro of Shakawe was also available to share his thoughts and experiences on the subject.

He said people in rural areas who defecate in the bush at times end up stepping on the poop and carry it on the soles of their shoes. This, he said, results in people eating their own poop. “If you do not wash your hands you end up eating your own sh*t,” Diziro said. He said people end up blaming witchcraft when they get infections from “eating their own poop.”

CLTS is a methodology aimed at promoting Open Defecation Free (ODF) Communities through provision of sanitary facilities hence reducing morbidity and mortality rate of infants due to diarrheal diseases.

MoH says having monitored implementation of the methodology under the USAID ÔÇôfunded Southern African Regional Environmental Program (SAREP) in the North West District, they have realized that the community based strategy bares fruits as it is based on community leadership commitment. This is perhaps why they have engaged community leaders like kgosi Diziro to lead the campaign.

They say CLTS is based on the premise that the community can become open defecation free (ODF) only if all members genuinely feel a need for sanitary toilets.

MoH says the impact of poor sanitation and hygiene behavior on preventable diseases is widely recognized, but the CLTS approach is proving to be the most successful methodology in improving rural sanitation world-wide.

According to the MoH, there is widespread open defecation in rural areas and diarrhoea has increased in these areas since 2010.

“Remote rural communities have few formal sanitation options; furthermore, toilet facilities requiring water supply may not be viable in arid areas.”

In 2011 the government reported 183 deaths over a period of three months due to diarrhoea outbreak. Responding to a question in Parliament at the time, Assistant Minister of Health Gaotlhaetse Matlhabaphiri revealed that a total of 171,280 diarrhoea cases were recorded between 2006 and 2011. Within that period, about 1,820 children under the age of five succumbed to the disease.
The highest death toll was registered in 2006 when 54,296 cases were reported along with 649 deaths.

The CLTS initiative in Botswana is supported by the American people through technical assistance from the United States Agency for International Development (USAID) under its Southern Africa Regional Environmental Program (SAREP). SAREP works collaboratively with the Permanent Okavango River Basin Commission (OKACOM), the Botswana Government and local authorities to improve water and sanitation supply to Okavango Basin Communities.


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