The Sanitation Crisis

Public Health Impact

2.3 billion people around the world lack access to basic sanitation. This means that they have to defecate in open sewers, rivers, or street gutters instead of using clean toilets. These actions cause the spread of faeces around communities. If a person was to come into contact with human waste, their chances of becoming infected by diarrhoeal diseases significantly increase. Diarrhoea kills more than 1.4 million people per year, with poor sanitation, hygiene and water access (WASH) being the cause of 58% of these deaths. The World Health Organisation (WHO) have found that poor sanitation is a direct cause of over 280,000 deaths annually. In Kenya, a cholera epidemic occurs every 5-7 years and often lasts 2 or 3 years, with outbreaks of the disease occurring every single year. In 2017 there were over 4,000 cholera cases. 

The sanitation crisis is particularly strife in informal settlements and refugee camps. These groups are considered the most at-risk population; high population density and inadequate sanitation facilities provide an environment that perfectly incubates disease. Northern Kenya hosts 84% of the country's 468,000 refugees (Sept. 2018) in two main camp complexes: Dadaab camp (44%), and the Kakuma and Kalobeyei camps (40%). The remaining 16% of refugees are hosted in urban areas, mainly in Nairobi. Turmoil in the neighbouring countries of Somalia, Uganda and Sudan in the last 3 decades has meant that these camps have become semi-permanent features, with Kakuma camp being 26 years old and Dadaab camp 27 years old.

Our founder has had previous experience in the sanitation industry in Kenya through his work developing the 'UNICEF manual for WASH in primary and pre-primary schools in Kenya' (2017). Through this, basic principles for good sanitation facilities were defined and brought to the attention of UNICEF and the Government of Kenya, through an effort to standardise and fund all schools in Kenya to an adequate level of sanitation. An increasing exposure through international media surrounding outbreaks of cholera has put pressure on aid agencies such as UNICEF and UNHCR (refugee branch of the United Nations) to achieve sanitation goals in Africa.  


The Pit Latrine

One of the key causes of poor sanitation is the lack of proper design in typical toilet facilities. The style that is commonly used in sub-Saharan Africa is called a 'Pit Latrine' and is made by digging a hole in the ground and placing a concrete slab over over it with a hole in the middle. The above photograph is of a ventilated improved pit (VIP) latrine which, while neglected, has put principles of good sanitation design into practice. In many cases, the below-ground structure is often overlooked, without any supports in place or lining for the pit, which allows the waste to seep into the surrounding soil. This weakens the soil structure, and in some cases this can lead to the collapse of the pit and death; in May 2018 a toilet block collapsed in Mombasa, causing the death of five children and one adult at a wedding ceremony. Seepage of waste has further reaching issues as well, with the possibility of the waste entering ground water sources such as wells and boreholes if built too closely. This can contaminate an entire village's water source, exposing all inhabitants to diarrhoeal diseases. 

The above-ground structure often used when building pit latrines promote flying insect cultures. These spread human excrement around the village onto food, surfaces and people's skin. One way to combat this, which we have incorporated into the BioFactory, is to design a ventilation path that draws fresh air into the latrine and out a chimney connected to the pit. This makes it harder for insects to return into the latrine through the toilet, and also provides a more pleasant environment for the users. Fly-sheets at the top of the chimney prevent the insects escaping. Another way to combat the flying insect problem is to keep the latrine dark and shaded. The light from the top of the chimney now further attracts insects away from the latrine.