Grandma, Why Not the Toilet? A Real Talk on Open Defecation

Hello Reader!

Welcome to the first edition of this newsletter where you get to follow my health conversations with Grandma.

Why this?

Grandma thinks she "knows all". Meanwhile, her perspective is full of beliefs and practices that can be detrimental to health. I never miss an opportunity to educate her accurately. Because she is my Grandma, I make sure to use simple and friendly words that will enhance her understanding.

My conversations with her are interesting and sometimes hilarious. That's why I thought of sharing with you.

In this edition, I addressed an important public health issue: Open Defecation.

Enjoy your read and don't forget to subscribe and share.

Yehhh!! Grandma has visited again and I'm so excited. 

We will all get to have a taste of our traditional cuisines and hear the latest news about everyone in the village!

I offered to take her bag inside and told her to freshen up and come have a taste of something I made specially for her.

Immediately she opened the toilet door, her face changed and she started mumbling some words.

I already knew she would complain and I am ready for some health conversations. 

Me: Grandma, why do you always complain about using the toilet? It’s cleaner, safer, and healthier!

Grandma: Ah, my child, you don’t understand. I grew up in the village, and we did our business freely in the open. No smelly, cramped space—just fresh air and nature!

Me: But grandma, open defecation is not just about comfort. It can spread diseases like cholera and typhoid, especially when rain washes waste into water sources. Would you want the little ones in the village to get sick?

Grandma: Hmm… I never thought about that. But still, I feel trapped in that small space!

Me: I get it. Change is hard. But proper toilets protect us from germs and keep the surroundings clean. Plus, they offer privacy and dignity. Wouldn’t you want that for the next generation?

Grandma: That makes sense. But what if there’s no toilet available?

Me: Then that’s something we should push for—better sanitation in every home and village. Health starts with simple choices, and using a toilet is one of them.

Grandma: Alright, you’ve given me something to think about. Maybe I can give this toilet thing another try!

Me: Alright Grandma. I'll be waiting for you to come eat.

What is Open Defecation 

Open defecation is when people defecate in the open – for example, in fields, forests, bushes, lakes and rivers – rather than using a toilet. 

It is the act of passing excreta in open air locations instead of in hygienic, covered locations. 

The phenomenon does not just occur in the rural areas of Nigeria but also in the cities, and among the educated class in public tertiary institutions, business and residential areas. 

Over 47 million Nigerians defecate openly in and on bushes, gutters, sidewalks, motor parks, recreation parks, rivers and streets amongst others.

 Some efforts have been made over the decades to reduce the cases of open defecation in Nigeria. 

Globally, the practice is decreasing steadily. One of the targets of the Sustainable Development Goals (SDGs) of eliminating this practice by the year 2030 requires a substantial acceleration in toilet use particularly in Central and Southern Asia, Eastern and Southeast Asia and Sub-Saharan Africa.

It will be a major Sanitation Challenge to achieve the elimination of OD by 2030, but helping the poorest currently plagued by OD and its serious adverse health effects should be our principal task as we seek to achieve the sanitation target of the Sustainable Development Goals.

UN agencies report that of the 673 million people practicing open defecation, 91 per cent live in rural areas. An increase in population in countries including Nigeria, Tanzania, Madagascar and Niger, but also in some Oceania states, is leading to localized growth in open defecation.

According to the findings from the 2021 WASH National Routine Mapping (WASHNORM) survey report, 47 million people in Nigeria practice open defecation. 

Accordingly, in 2018, the Nigerian President declared a state of emergency in the Water, Sanitation, and Hygiene (WASH) sector, demonstrating political will at the highest level of government, and launched a national campaign tagged 'Clean Nigeria: Use the Toilet' to jump-start the country’s journey towards becoming open defecation-free (ODF) by 2025.

The Adverse health effects of OD are many: 

• acute effects include infectious intestinal diseases, including Diarrheal diseases which are exacerbated by poor water supplies, sanitation and hygiene;
• adverse pregnancy outcomes; and life-threatening violence against women and girls.
• Chronic effects include soil-transmitted helminthiases, increased anaemia, giardiasis, environmental enteropathy and small-intestine bacterial overgrowth, and stunting and long-term impaired cognition.

Factors contributing to open defecation: 

• Lack of access to toilets,
• Traditional cultural practices, 
• Population growth
• ignorance and primitive lifestyles;
• Lack of water supply
• lack of necessary technology (especially in rural areas) for the appropriate toilet models;
• poor maintenance of facilities

The solutions to open defecation include: 

Intensified advocacy to the Nigerian populace to sensitise them to the prevalence, danger and solutions to open defecation. Private and public media originations should massively enlighten people on these.

Second, ‘hygiene laws’ ought to be made at the state and federal houses of assemblies criminalising open defecation, especially in the cities. Motor parks, shopping complexes, markets, restaurants, educational, financial institutions, all public and private buildings, communities, petrol stations, and recreation areas must have toilets with running water. No private building or business site plan should be approved without provision for toilet facilities. Those whose toilets are not properly maintained will be sanctioned appropriately. Each local government must have sanitary officials that bring the hygiene laws to bear by ensuring compliance.

Third, water supply should be made an important priority all over Nigeria. Each state and local government should acquire borehole drilling machines and sink boreholes in strategic areas, especially in rural areas.

Fourth, private organisations like banks, oil, insurance and manufacturing companies should donate latrines/toilets where needed across the nation as part of their corporate social responsibility (CSR). 

Fifth, technological innovations should be encouraged to building toilet models suitable to the environment and for the needs of the people. 

Now Grandma has promised to be an advocate for proper use of toilet when she travels back to the village.

What an interesting health conversation with grandma. I wonder what is next!

Until then…do have a great week ahead and remember to use the toilet properly and tell someone to do same.

Your's, Numtas Thomas