Open defecation and lack of proper sanitation remain a major problem that the county and national governments have been struggling to address for several years.
Despite the multi-faceted approaches that have seen the government splash millions of shillings into programs to change public perception of toilet use, open defecation remains a significant problem in the country.
Open defecation refers to the act of relieving oneself in the open, in fields, in bushes, in farms, or water bodies. According to the Ministry of Health, it is one of the health concerns the country continues to face.
In Western Kenya, health experts attribute it to increased cases of waterborne-related illness, which is a big threat to the lives of children, especially infants, exposed to it.
The situation in the country is so bad that statistics by Unicef indicate that the number of Kenyans still relieving themselves in the open has nearly doubled in the last five years.
However, in Kakamega, an initiative rolled out by the devolved unit in collaboration with USAID and community members is drastically transforming lives and ending in the homestead.
For the community of Bomini village in Mumias East, it is a case of enthusiastic family’s keen to finally strike the last nail of the coffin of cholera, dysentery, and malnutrition that they have always attributed to open defecation.
At Bomini, the mention of the Safe Toilets (sato) toilets and stools elicits a huge smile, and nearly all homesteads that have installed this type of toilet have moving testimony they are readily willing to share.
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The toilets are mechanical toilets with air-tight seals that close off latrines, keeping away insects that spread diseases after contact with human waste.
Additionally, the innovation entails a sato stool that helps those with disabilities effortlessly use pit latrines while seated. The sato stool is raised and provides a sitting area for users. It is made of plastic and installed in pit latrines using cement.
At Christanus Oranje's home, we watched in awe as he skillfully balanced his crutches and smeared a portion of ash on his hands before rinsing them extensively moments after visiting his toilet at his Bomini village in Mumias East.
Despite living with disability following a road crash in October 2018 that immobilized his legs and forced him to undergo hip surgery, Oranje has been effortlessly using his pit latrine without any help from his wives.
Three years earlier, he relied on his wives or children to escort him to the toilet and help him use the pit latrine. He also battled swarms of flies that used to invade the toilet.
“My family used to struggle with cases of frequent sanitation-related diseases at the time. It was a disaster, and I had to be helped whenever I wanted to relieve myself,” he explained.
He is among many families in Bomini village who got relief after embracing a new toilet innovation to improve sanitation and end open defecation.
“The stool has helped me. Although I am unable to bend my leg because of my disability, I no longer require help to relieve myself. I can use my crutches to go to the toilet with ease. I also don’t have to struggle with flies,” he says.
Open defecation is associated with bilharzia, intestinal parasites, increased child mortality rates, and contaminated environments.
A stroll in the lush green village with swathes of forests that used to provide perfect hideouts for open defecation reveals a rapidly changing trend that has improved sanitation.
Nearly all homesteads have a pit latrine fitted with Sato pan toilets. In homesteads with a family member with a disability, a Sato stool has been installed in one of the toilets.
While the toilets reserved for those with a disability have always been reserved for high-end hotels and ample government facilities, residents of Bomini have embraced it, too, for their pit latrines.
The project, a brainchild of Jaramogi Oginga Odinga University alongside Kakamega County under the United States Agency for International Development (USAID)’s Boresha Jamii Program, was drafted to drive change in sanitation.
According to Nancy Khatenje, a Water, Sanitation and Hygiene coordinator for the program, the initiative has helped authorities to declare 67 villages in Kakamega as open defecation-free.
“We started with an initiative to ensure that all homesteads had a pit latrine. It was dubbed ‘bora choo (as long as it is a toilet),’” she says.
Through collaboration with other stakeholders, they trained about 150 community health promoters to encourage families to build toilets. Several homes then became interested in the innovation.
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Last week, a spot check by The Standard established that more homes have installed the new toilets, and residents are not shying away from sharing how the toilet is a health masterstroke that has helped them solve sanitation problems.
The village is so organized that it has set up a health committee to visit homes and educate residents on the need to embrace toilet use to end open defecation.
Alex Makhoha, a community health committee member, says they have been visiting homes to encourage them to build toilets.
“We are a group of volunteers keen to end problems like diarrheal diseases that were a big problem in the area in the past,” he says.
He says since they embraced door-to-door community health talks, they have been able to encourage all households to build toilets.
He says most households prefer to build Sato toilets because they improve sanitation by keeping flies away.
At the homestead of Fatuma Saidi, there are three toilets, all of which have been fitted with Sato toilets.
“There are no flies in the toilets and no smell. This has greatly improved our hygiene,” she explains.
Several kilometres from where her homestead lies at Bomini B sublocation, Wilberforce Kweyu is busy inspecting his newly installed Sato toilet.
Kweyu is a local artisan helping homeowners construct their toilets and install the innovation and is among 150 volunteers trained in installing the mechanized toilet.
“I was trained by experts from JOOUST and the county government on how to install the toilets, and I am now honoured to serve the community,” he says.
He says he has installed more than 60 Sato toilets and stools in his village since December last year.
“I do charge about Sh1500 for buying materials like cement and also labour to install the toilets,” he says.
In some cases, however, families unable to raise money for labour trade their chicken or farm produce for the toilets in a batter-trade model embraced by the community.
Families have also installed a tippy tap outside every toilet, another sanitation innovation complementing the Sato toilets.
Almost every household has erected the device in their compound, using only a stick as a lever, ash drawn from their kitchens, soap, and a container.
After visiting the toilets, they wash their hands with ash drawn from kitchens, a substitute for expensive soap.
According to USAID’s chief of party, Dr Solomon Orero, ash was to encourage families to use their readily available local interventions to improve sanitation.
“The toilets have improved sanitation, and more families are now aware of the need to embrace proper sanitation to help improve their health and well-being,” he explains.
Last year, Governor Fernandes Barasa’s administration directed all homes to construct toilets to help improve sanitation and reduce waterborne-related diseases.
According to county government records, the sub-county has not recorded any cholera outbreak since April 2023.
This has been attributed to improved sanitation and an increase in toilet coverage.
According to the United Nations, more than 800 children under five die every day from diarrhoea caused by unsafe water, poor sanitation, and hygiene.
Globally, Kenya is one of 26 countries responsible for 90 per cent of the world’s open defecation.
According to the Ministry of Health, the country has set a 2030 deadline to ensure all homes have access to proper sanitation but is also banking on partnerships to help achieve that goal.
Similarly, the World Bank contends that Kenya loses about Sh27 billion in avoidable treatment, with the government forced to invest heavily in tackling diseases attributed to a lack of proper hygiene.
Residents of Mumias East who have embraced the new latrine usage method claim they have had fewer hospital visits for sanitation-related illnesses.
However, Kweyu contends that some families have yet to embrace the system, claiming the costs are high.
“I have been offering to help and even accepting gifts such as chicken as labour costs, but some are still reluctant. They also have to buy cement, which may be expensive at times,” he says.
