Is open defecation source of Zim’s health crisis?

Lazarus Sauti

Zimbabwe is scrambling to contain an outbreak of typhoid, with 2 160 cases reported which had led to seven deaths earlier this week.

The Ministry of Health and Child Care says typhoid is a major concern in various parts of the country.

“The cumulative figures for typhoid are 2 159 suspected cases, 77 confirmed cases and seven deaths,” the ministry said in its weekly briefing.

There were 10 suspected cases of cholera with three of them confirmed and one death reported. 

Health and environmental experts believe open defecation – the practice whereby people go out in fields, bushes, forests, open bodies of water, or other open spaces rather than using the toilet to defecate – is greatly to blame for waterborne diseases such as typhoid and cholera currently affecting Zimbabweans.

Nationally, 37 percent of rural households still practice open defecation, according to statistics from an annual Zimbabwe Vulnerability Assessment Committee (Zimvac) report for 2016.

“Zimbabwe is battling with waterborne diseases like typhoid and cholera, thanks to open defecation, poor water quality, uncollected waste in urban and semi-urban areas as well as unhygienic practices,” says water and sanitation expert, Matthew Chiramba. “Open defecation is the source of organic, bacterial, ground water and surface water pollution. It also pollutes catchment areas.”

He adds that open defecation also impacts on personal dignity, especially on women and girls as they risk shame, disease, harassment and attacks.

Environmentalist, Edson Nyahwa, says open defecation is a serious environmental as well as health and safety issue confronting Zimbabweans as improperly disposed human waste not only pollutes water, killing plants and fish, but also releases methane gas into the atmosphere which is part of the green house gasses that cause global warming.

“Open defecation should be equated to an environmental as well as health crime. It impacts negatively on socio-economic development and should not be tolerated if the country is to attain the Sustainable Development Goal (SDG) on sanitation,” he adds.

Harare City Council Health Services director, Dr. Prosper Chonzi, believes stakeholders should put a lot of effort towards addressing environmental issues that drive waterborne diseases such as typhoid and cholera.

Nyahwa also says that the management of wastes must be considered, and conventional sewerage should be supplemented with ecological sanitation technologies that make use of nutrients in human waste.

“The government, at every level, and stakeholders in environment, water and sanitation sectors should invest more in the provision of water and public toilets, create awareness on the dangers of open defecation as well as encourage the anaerobic digestion of sewage to produce biogas for energy,” he adds.

Traditional leader, Robson Wagoneka, says open defecation, which he also considers as a well-established traditional practice deeply ingrained from early childhood, reduces the aesthetic beauty of an area, and believes social norms and habits need to be changed if the practice is to be eliminated.

“Building public toilets is a good move and vital for improving the lives of people, especially the poorest, but honestly it will not do the job,” Wagoneka says. “Changing social norms and habits will achieve the desired goals.”

He also urges the government to support as well as strengthen the participation of local communities in improving water and sanitation management.

Wagoneka adds that there is a serious need for health education and promotion on personal hygiene, a fact supported by Dr Portia Manangazira, the Director in the Ministry of Health and Child Care responsible for Epidemiology and Disease Control, who adds, “There is also need to avail resources for the training of more health personnel so that they gain understanding of diagnosing diseases such as typhoid as well as cholera and quickly put patients on medication.”

In-depth research, notes the Zimvac (2016) report, is required to understand the casual factors of the relatively high prevalence of open defecation across the country.

“The government should also promote demand-led approaches that involve systematic and structured information, education, and communication and inter-personal communication elements to better hygienic practices needed for effective uptake of interventions, with a particular focus on behaviour change,” the report adds.

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