Shaping East Africa’s sanitation solutions, for hygiene, education and resilience

7 min read
Chris Tumwine standing in the street in Kampala, Uganda.
Image: WaterAid/Ruth Mbabazi

East Africa is one of the fastest-urbanising regions on the continent. It also contains three of the ten countries worst affected by climate change. Here, we share case studies from our work in Uganda, Tanzania and Ethiopia, showing how communities and governments are working to meet these challenges to everyone having access to decent toilets.

Globally, around 4.5 billion people lack access to adequate sanitation, putting them at risk of deadly diseases by forcing them to either practise open defecation or use unsafe facilities. In many regions, rapid urbanisation, poor urban planning and climate change converge to present huge challenges to provision of clean water, decent sanitation and good hygiene (WASH), and threaten often fragile sanitation systems.

Rapid population growth in cities and towns in the region is putting ever-increasing pressure on urban infrastructure, including access to WASH services. City planning can be a key factor, adding stress on sanitation infrastructure and facilities – inadequate planning can result in blockage of drains and rivers becoming dumping grounds for sewage and rubbish.

Climate change exacerbates these risks, the increasingly frequent and severe floods it is causing putting additional tension on sanitation systems and infrastructure. In 2019–20, extreme rainfall in East Africa linked to climate change caused serious flooding across countries including Ethiopia, Uganda and Tanzania. The floods destroyed many homes and shelters across the region, posing additional challenges to the realisation of Sustainable Development Goal 6 on water and sanitation. Such heavy rains in the region are predicted to become more frequent because of climate change.

While these sanitation challenges are significant, they also present opportunities, as this collection of stories from East Africa shows.

Community-led solutions in Uganda

Although access to improved sanitation in urban areas of Uganda has grown to 89.1%, coverage of safely managed sanitation (which hygienically separates human excreta from human contact) is just 39.2%.

Provoked by the sanitation crisis in his community in Kamwokya, Kampala, which suffers from the effects of a poor sewer system, poor garbage disposal and flooding, community WASH advocate Chris Tumwine (pictured above) asked, ‘how do we fix it?’.

Chris joined the Weyonje (‘Clean yourself’) Campaign, a movement championing inclusive sanitation and hygiene awareness in communities across Kampala. An initiative of Kampala Capital City Authority, WaterAid Uganda is among the partners supporting the movement, funded by the H&M Foundation as part of our SusWASH programme.

According to Mayor of the Kampala Central Division, Sserunjogi Charles Musoke, the issue is complacency: "People get used to the situation," he said.

The rise of Weyonje

Through the support of the Kampala Capital City Authority, a bigger Weyonje team was assembled in Kamwokya to help spread WASH understanding. Although there was some resistance from the community, the team worked hard to achieve their buy in.

According to Susan Lalam, a member of the Weyonje team, people welcomed the campaign and its objectives. Susan's dream is to have a community where you could look around and not see anything unsanitary. She hopes Weyonje’s work will reduce the number of people going to the hospital for preventable illnesses linked to WASH, such as diarrhoeal diseases.

The Weyonje Campaign is a reflection of the Government's commitment to prioritising public health. According to the mayor, Kampala Capital City Authority is increasing funding for managing proper sanitation.

"We could not do it alone," said Musoke. "We have partners, and one of them is WaterAid. They are taking me for training as a politician, so that I can enhance and help other politicians to appreciate the importance of good sanitation."

Creating sustainability in ‘the ghetto’

To boost the sustainability of Weyonje’s work, Chris reached out to other community leaders, such as Patrick Mavo, aka Ticha Mavo, the founder of Ghetto Research Lab. Mavo’s organisation develops innovative projects that improve the lives of Kamwokya residents living in poverty, while solving environmental pollution. Ghetto Research Lab employs more than 400 young people, who collect would-be-waste and re-use it to create jobs and wealth.

Through working with other community leaders like Mavo and Government actors like the mayor and Kampala Capital City Authority, Chris and the Weyonje team convinced Kamwokya residents to come together to sign The Kamwokya Sanitation Declaration, committing to build toilets where necessary and keep them clean at all times – a significant step towards sustainable urban WASH.

Sserunjogi Charles Musoke, Central Division Mayor, signing the community declaration on toilets during World Toilet Day celebrations in Kampala, Uganda.
Sserunjogi Charles Musoke, Central Division Mayor, signing the community declaration on toilets during World Toilet Day celebrations in Kampala, Uganda.
Image: WaterAid/ James Kiyimba

Fighting COVID-19 together

Kamwokya, less than half a square kilometre in size, is home to more than 6,000 people, making social distancing and other COVID-19 safety measures difficult to follow. But that hasn’t stopped the Weyonje team encouraging safe behaviours.

They use a community WhatsApp group to share information and to counter misinformation about COVID-19 circulating on social media. They carry out house-to-house community education about proper and regular handwashing with water and soap as a first line of defence against the spread of coronavirus. And, since many homes in Kamwokya don’t have easy access to water sources, the team has created makeshift handwashing stations – plastic bottles filled with soap and water and tied to residents’ front doors, so they can wash their hands before entering their homes.

Partnering with the Government in Tanzania

In Temeke District in Dar es Salaam, WaterAid Tanzania has been a key partner to the Government, through the utilities, in constructing a faecal sludge treatment plant. The plant recycles sludge and wastewater into fertiliser and biogas, helping Temeke residents manage waste in a crowded city with few sewers, and producing useful materials.

Temeke District, one of the most populated towns in Dar es Salaam, has been heavily affected by flooding. Teodora Nzingo, below, lives in the coastal ward of Kigamboni, where flooding prevented her from using her toilet and stopped sanitation services from accessing it.

Teodora Nzingo, nearly 80 years old, showing how the flood waters have gone into the water storage tanks and filled up the pit latrines so causing more flooding in Kigamboni, Tanzania. January 2020.
Teodora Nzingo, nearly 80 years old, showing how the flood waters have gone into the water storage tanks and filled up the pit latrines so causing more flooding in Kigamboni, Tanzania. January 2020.
Image: WaterAid/ Sam Vox

"The floods have also brought challenges to the toilet. It is causing me difficulty," she said. "When the sanitation business came to empty my pit latrine, they couldn’t because the flood water had gone into the storage tank. So, I can’t empty the toilet, and it is full. I can’t use it anymore."

Technologies such as the Decentralised Wastewater Treatment Systems (DEWATS) that WaterAid Tanzania constructed in Kigamboni and Temeke Municipality are climate-resilient solutions to sanitation that enable safe, hygienic pit emptying and safe disposal of waste.

These solutions are just the beginning for sustainable sanitation in Tanzania. Government development plans, which WaterAid urban WASH planning will feed into, include the expansion of city-wide inclusive sanitation, urban settlements planning, mainstreaming climate risk mitigation, adopting sanitation technologies and services, and integration of sanitation in the development of the master plan, especially in growing or small towns. This will greatly contribute to sustainable sanitation for all.

Gender equality through inclusive sanitation in Ethiopia

In 2018, the Ethiopian President’s National Initiative was launched to address gender equality, peace building and social development through civic engagement. WaterAid Ethiopia partnered with the President’s Office through the Initiative to advocate access to WASH for women and girls as a key enabler for inclusive and quality education, particularly as schools reopen after COVID-19 closures, to unleash girls’ and women’s potential to influence Ethiopia’s development.

In Atse Nakutole’ab co-educational school in Gulele sub city, Addis Ababa, 673 students and 67 members of staff shared just one toilet block with eight cubicles. With the Ethiopian President’s National Initiative, we supported the school to build two female-friendly and disability-friendly WASH blocks with five cubicles each, a resting room for girls to use during menstruation, a waste disposal facility for used sanitary pads and a water storage tank.

Schoolgirls Bemenet, Nohamin and Meraf outside the newly constructed facility for menstrual hygiene management, toilets and water at Atse Nakutole’ab school, Addis Ababa.
Schoolgirls Bemenet, Nohamin and Meraf outside the newly constructed facility for menstrual hygiene management, toilets and water at Atse Nakutole’ab school, Addis Ababa.
Image: WaterAid Ethiopia

Students Bemenet, Nohamin and Meraf (above) said "Menstruation has its own stress until you understand what is happening to your body. Sometimes we even feel that it’s a kind of a disease and not a natural process. So, we will try to teach our youngsters about menstruation and how to use the rest room if they need to use it in the future." The school has plans to integrate hygiene education into its curriculum, to help students to benefit as much as possible from the improvements to school facilities.

Yenensh Welde Michael, Atse Beakutole’ab school’s toilet cleaner, getting ready for her shift.
Yenensh Welde Michael, Atse Beakutole’ab school’s toilet cleaner, getting ready for her shift.
Image: WaterAid Ethiopia

School cleaner Yenensh Welde Michael has seen a huge difference in the sanitation and hygiene facilities, reporting that they are much easier to clean, attractive and comfortable for girls. The success of this model is a key avenue for further advocacy engagement, to influence key decision makers and raise funds for similar initiatives.

The future of our sanitation response in East Africa

Water, sanitation and hygiene form an essential platform for progress in health, education, work, and economic growth and development. Increased, sustained investment in climate-resilient and inclusive sanitation facilities and infrastructure is a vital part of ensuring everyone can access these vital services, giving communities a chance to be healthy, educated and break out of extreme poverty, whatever the changing climate brings. We will continue our work across East Africa to support governments and communities to build the resilience of WASH systems, infrastructure and services, ensuring the human rights to decent sanitation are claimed and upheld.

Written by Alex Busingye, Neema Kimaro, Gloria Kafuria, Hilina Nigussie, Elizabeth Mwambulukutu, Dedo Mate-Kodjo and Ronnie Murungu of WaterAid East Africa. Follow WaterAid East Africa on Twitter @WaterAidEA.

A version of this article was first published on The East African.