Why there is urgent need to improve access to toilet facilities in Ghana

Long queues formed by men and women both young and old, are the regular spectacle one is likely to chance upon at many public toilet facilities in the urban areas of Ghana, particularly in the early mornings. Such scenes are not limited to the national capital, Accra, but to all other big cities in the country, including Kumasi, Takoradi, Cape Coast and Sunyani.

These people stand in queue in wait of their turn to attend to nature’s call. They have come to empty their bowels after a long night of sleep. It is a daily routine for many urban dwellers in Ghana, particularly those who do not have toilet facilities in their homes and do not also want to engage in open defecation. This means that to avoid any queue, one had to be at the public toilet facility early enough. You get there late at your own discomfort.

Philip Otchere (not his real name) lives at Kojo Sardine, a suburb of Accra and wakes up 5a.m every morning to be able to make it to the nearby public toilet in his hood. He does this in order to avoid being in any queue. His house, which has no toilet facility, is about 300 metres away from the toilet facility.

Philip is a national service personnel who has just relocated from Kumasi to the national capital to undertake his one-year mandatory national service after graduating from the Kwame Nkrumah University of Science and Technology (KNUST). In Kumasi, he had a personal toilet facility in his single-room self-contained accommodation.

Now in Accra as a fresh graduate from the university, he has not got a two-year advance to pay for a self-contained single-room accommodation near the institution where he is undertaking his national service.

A single-room self-contained, that is, a small room of about 12 feet by 13 feet with toilet facility at Spintex, a suburb of Accra, where he is doing his national service, is going for GH¢350 a month and the property owner wants two years advance. Obviously, Philip cannot afford to raise GH¢8,400 for the two-year advance. He therefore had to contend with a low-cost room which has no toilet facility in it at Kojo Sardine—GH¢200 a month for one year. At Kojo sardine, the landlords is willing to take only one-year advance.

“The cost of the rent here is good but there is no toilet facility there and so I had to use the public toilet. If you get there early, at least, you will find the place a bit clean. However, if you wait and go after 6a.m, the place will be messed up,” Philip noted, adding “I also don’t want to be in queue.”

Like Philip, many residents of slum-like areas in Accra and other major cities in Ghana do not have access to personal toilet facilities in their rooms and had to use public toilets or shared ones, which are usually unhygienic and unsafe to ease themselves.

Many rented accommodations in Accra do not have toilet facilities in them. This makes it very difficult for residents in these accommodations to find convenient ways to ease themselves when needed. And sadly, many public toilet facilities where those without toilets use also face serious maintenance problems.

Ideally, public toilets are usually meant for visitors to the city and not for residents. However, the reverse is the case in most parts of Ghana’s urban cities. Public toilets have become permanent features for most residents in Accra.

It is an eyesore to visit some public toilets in Accra. The facilities are not well maintained, cleaned or fumigated, hence putting the lives of those who patronise such places at risk of getting infections and contracting other diseases.

It is sad to say that due to the lack of access to toilet facilities, many people in Ghana engage in open defecation, a practice that is an affront to the dignity of any civilised human society.

For instance, the Okai Kwei South Municipality in the Greater Accra region on November 2, 2022, arrested 16 people for defecating in the open in the area. Others were arrested for pouring liquid waste into drainage systems.

The Head of Public Affairs at Accra Metropolitan Assembly (AMA), Gilbert Nii Ankrah, say some of the offenders were proceed for courts whilst others were given spot fines.

Access

Access to improved sanitation facilities such as personal toilet facilities is critical in any human society as it contributes to improved health and well-being of individuals and communities.

However, globally, over 2.5 billion people live without access to safe sanitation facilities and more than 40 per cent of the world population, do not use a toilet, but defecate in the open or in unsanitary places.

According to the 2021 National Housing and Population Census of Ghana, about 18 per cent of households do not have access to a toilet facility with the proportion being over three times as much among rural (31.3%) as urban (8.9%) households.

Rural households (5.1%) dominate the use of unimproved toilet facility relative to urban areas (1.1%), and show wide disparities across the regions ranging from Upper West (21.9%) to Greater Accra Region (3.4%).

The census report again indicate that open defaecation is prevalent in all the 16 administrative regions of Ghana, with five regions recording more than 50 percent. What it means is that about 5.5 million people in Ghana still practice open defecation.

Even though many assemblies have laws that require landlords to provide toilets for their tenants, with associated penalties for defaulters, many rented accommodations still do not have toilet facilities in them. This is because offenders are often left off the hook.

Efforts

The United Nations recognises access to water and sanitation as human rights and further as rights that are interlinked with the realisation of human dignity.

In 2013, the World Bank financed the $150-million the Greater Accra Metropolitan Area (GAMA) Sanitation and Water Project to support the Government of Ghana’s efforts to increase access to improved sanitation and improved water supply in the GAMA, with emphasis on low-income communities and to strengthen management of environmental sanitation in the GAMA. Beneficiary households and institutions pay 30 per cent of the cost. The project has so far constructed about 30,000 household toilet facilities in the beneficiary communities.

Similarly, UNICEF has been working to draw the attention of the private sector's interest into ending open defecation and making Ghana cleaner country. For instance, UNICEF collaborated with SNV, a Dutch International Charity to introduce the concept of Village Savings and Loan Associations. This enable community members who cannot readily afford toilets to do so with a loan and pay at a later date. It was implemented in three towns and regions of Ghana, Ashaiman in the Greater Accra region, Tamale in the Northern region and Ho in the Volta Region.

Private sector initiative

Santez Biofill Ltd, is a private business that trains people in the construction of household toilet facilities known as “biodigester”. The biodigester toilet system utilises the anaerobic digestive process to break down and clean toilet waste – the result is less solid waste, relatively clean water output and the release of harmless gas into the environment.

This tech-led toilet facilities can be constructed with just a few pieces of blocks and they do not require large space, hence making it comfortable for most property owners to build them in their homes.

Mr Ishmael Ganiu, who is the Chief Executive Officer of Santez Biofil Ltd believes that the introduction of biodigester toilets will go a long way to help improve access to toilet facilities in Ghana.

“Biodigester toilet does not require a big space to construct and they are very hygienic so most landlords and home owners prefer it to other forms of toilet constructions,” he explained, adding “I can tell you that there is no new house in Ghana that has not constructed biodigester toilet. They do it because it is faster, much easier to maintain, less costly and needs smaller space.”

For Ganiu, even people with little incomes are able to construct biodigester toilets, urging the government to really invest in that space to help improve access to toilet facilities.

For him, his company has so far trained more than 1000 people in the construction of biodigester toilet facilities for people.

He further explained that aside people learning how to construct their own biodigester through their initiative, trainees can also construct it for others to earn some incomes.

“When you learn how to construct biodigester, you have actually benefited in two ways—one, you can construct your own toilet facility and secondly, you can do it for others for money,” Mr Ganiu noted.

He wondered why in spite of the several opportunities associated with biodigester toilets, the government has not paid much attention to the concept to end open defecation in Ghana and also create jobs for the youth.

Just like Ganiu, Ms. Abigail Addai Sarpong, a Deputy Communications Officer of Yebi Ma Africa, a non-governmental organisation with focus on sanitation and environment, believes that the private sector, including non-governmental organisations can step in to help homes to own their own toilet facilities.

“There is the need to provide support mechanisms and policies to ensure that all persons in Ghana have access to safe toilet and sanitation facilities,” she noted.

“We have organisations that train people in the construction of biodiesgter toilets. The government can therefore collaborate with the NGOs to build the capacities of these trainers so that the training can be conducted at different locations, particularly where open defecation is high,” she explained.

Aggressive actions

She has therefore appealed to authorities of all the Metropolitan, Municipal and District Assemblies (MMDAs) across Ghana to ensure that they only grant building permit to building plans with toilet facilities in them.

“Landlords without toilet facilities in their house should be sanctioned. Until that is done, we will continue to witness these types of public toilet facilities in Ghana. Why would anybody construct an accommodation for renting and forget to construct a toilet in them?” She quizzed.

“It is a shame that we still have houses in Ghana’s urban areas without toilet facilities; it is highly unacceptable,” Ms Sarpong noted.

She explained that lack of toilet facilities in rented accommodations only breeds open defecation, saying “Open defecation will fester if people do not have access to toilet facilities. That is why there is an urgent need for all assemblies to ensure that no rented accommodation without toilet facilities is allowed to rent to tenants.”

In an article written by Sanyu Lutalo, a sanitation expert on November 15, 2018, titled: “Improving’ versus ‘improved’ sanitation: the case of shared toilets in Ghana”, the author said: “Moving from open defecation to the use of public and shared toilets, and ultimately to individual toilets, calls for tremendous effort involving many stakeholders. This effort is not just in terms of making physical investments but, more importantly, in effecting behavior change to maintain the momentum to move towards the top of the ladder and, once there, to ensure that facilities are properly operated and maintained.”

The Minister of Water and Sanitation, Madam Cecilia Abena Dapaah during the celebration of the 2021 World Toilet said: "It is an acknowledged fact that in a community where people don't have access to well managed toilet, every other person's health is under threat, this is because poor handling of faecal matter contaminates our drinking water, and leads to outbreak of various diseases."

Similarly, the Minister at the 2021 Mole Conference advised ladies not to even accept proposals from suitors who do not have toilet facilities in their homes.

“If you are a lady getting married or engaged, and the young man has no toilet in his house, don’t agree.” Mrs. Dapaah is quoted to have said at the 32nd Mole WASH conference at Ejisu in the Ashanti region.

For the Minister, it will take a very radical approach to take Ghana off the list of shame, the register of countries that practice open defecation.