City public toilet shortage sparks health crisis

KCCA public toilet at City Square, Kampala. Kampala has suffered annual outbreaks of typhoid and cholera and other communicable diseases, all linked to poor sanitation, costing lives and wealth. FILE PHOTO

What you need to know:

  • The need. With more than 4.5m people traversing Kampala daily, the scarcity of public toilets predisposes the burgeoning population to health risks, writes Amos Ngwomoya.
  • Dr Charles Niwagaba is a lecturer at Makerere University’s department of civil and environmental engineering and noted in an interview for a story that this newspaper published in March, this year, that 46 per cent of Kampala’s faecal sludge remains uncollected.

In downtown Kampala, there is a cacophony of activity and thousands of humans mill in the fast-paced business hubs with urgency in their steps that creates tension and disorder.

If it is not a shoe dealer loudly smacking sandals on Namirembe Road to arrest the attention of potential buyers, it is a taxi tout menacingly beckoning commuters or a porter with baggage on the upper back angrily hollering to everyone to steer clear.
In the civic area, suited men and high-heeled women straddle with aura of sophistication. The city dwellers fan out to bars and eateries for meals that they patronise.

City Hall estimates that the day-time population of Uganda’s only capital at 4.5 million, dwarfing the resident population that the 2014 National Housing and Population Census puts at the 1.5 million.
The latter is the figure upon which the government and City Hall plan for and allocate resources, meaning social services in the capital are overwhelmed when the fleeting day-time population rises three-fold. A huge population too births diverse problems. And for Kampala, these range from political quarrels to broken infrastructure, rising crime, clogged drainage and flooding of streets during downpour as well as poor sanitation.

According to Kampala Capital City Authority (KCCA) Spokesman Peter Kaujju, one per cent of city households, which grossed 414,400 according to a 2014 census, have no toilets or latrines. The problem of inadequate sanitation facilities, which in the capital’s case directly affects 4,144 households, is compounded by public toilets that are few and far between.

There are only 16 of them to serve the city’s burgeoning population. The closest are five to 10-minute walk apart while anyone accessing the city from the east will, after passing Nakawa Market, find another public toilet only at Centenary Park, some three kilometres away. These distances inconvenience when a person is in urgent need to answer nature’s call.

In September, last year, the then Arua Municipality Member of Parliament Ibrahim Abiriga, who was assassinated in June, became a poster child of urban nuisance after an unknown person captured him on a cellphone camera urinating on the perimeter wall fence of the ministry of Finance headquarters in the inner-city.

Abiriga, until then known as a mascot of the ruling National Resistance Movement (NRM) party for his infatuation with yellow attire, later said he had drunk Coke and was under immense pressure to urinate yet there was no nearby public toilet at nightfall. The City Hall convicted and fined him Shs40,000, making him the most high-profile politician in modern Uganda to be punished for answering nature’s call at the wrong place. Abiriga was no exception, and his predicament mirrored the widespread problem of thousands.

It also was an indictment of City Hall obliged under the KCCA Act to, among other things, provide public lavatories and urinals as well as sanitary services for the removal and disposal of all kinds of refuse and effluent.
Dr Charles Niwagaba is a lecturer at Makerere University’s department of civil and environmental engineering and noted in an interview for a story that this newspaper published in March, this year, that 46 per cent of Kampala’s faecal sludge remains uncollected.

As a lead consultant for Kampala Feacal Sludge Management (FSM), a Bill and Melinda Gates Foundation project for improving sanitation in the city, Dr Niwagaba said the unpicked human waste ends up in either side drains or indiscriminately dumped in the open. The problem is more manifest in the slums and central business district where some residents defecate in polythene bags, which they call ‘flying toilets’, which they lob from their homesteads into open areas.
In Kampala’s case, Makindye, which is the largest of the five divisions, has no public toilet, an irony officials cannot explain. KCCA says it is not sitting on its laurels and has launched a home-to-home hygiene campaign dubbed Weyonje, a Luganda word for ‘be clean’.

There is a plan to fast-track construction of more public toilets.
“We are aggressively moving to build more through partnerships. The plan is to build 200 toilets by 2020 in markets, parks and some vulnerable communities and they will be modern toilets at least in every Ward,” he said.
KCCA would not disclose the cost of the planned project, whether the money is provided in its budget or when actual construction would commence.

A senior government engineer said a modern toilet, with extensive plumbing, tiling and water piping, could cost anywhere between Shs5m to Shs7m per stance.
There are up to 2.4 billion people in the world without access to basic sanitation services such as toilets or latrines, according to the United Nations Development Programme (UNDP). Clean water and sanitation is one of the seventeen Sustainable Development Goals that the United Nations General Assembly adopted when Uganda held its rotational presidency, making the country’s capital’s sanitation situation of interest even on a global scale.

In a May 2018 Uganda Sanitation Diagnostic Study Report for World Bank titled, Reviewing National Sanitation to Reach Sustainable Development Goals, the authors; Jim Gibson, Kathy Eales and Chris Nsubuga-Mugga, note: “Good sanitation matters for many reasons, but particularly for human dignity, public health, and environmental protection, and especially water.

The consequences of poor sanitation include water pollution, cholera, typhoid, stunting, lowered immunity to malaria, tuberculosis and human immuno-deficiency virus (HIV) arising from worm infestations, and girls not completing their schooling because of inadequate provision for menstrual hygiene management.”
And Kampala has suffered annual outbreaks of typhoid and cholera and other communicable diseases, all linked to poor sanitation, costing lives and wealth.

Traders, KCCA fight over toilets
Owners of commercial buildings in Kampala have rejected President Museveni’s proposal for them to open toilets for free use by tenants.

The President made the proposal after tenants bombarded him during a tour of the inner city that business had become costly due to multiple tax obligations yet demands by landlords for additional pay for toilet use, in addition to high rents, was chipping away profits. The property owners charge tenants and their customers Shs200 to Shs500 per use of the facility. Land lords, however, say the toilet levy is necessary to keep it clean and usable.

Kampala Capital City Authority (KCCA) joined the fray by directing the landlords to open the sanitation facilities for free use by both tenants and members of the public.
Rather than oblige, the property owners have challenged KCCA to build more public toilets instead of downloading its responsibility on them.

“Let them build public toilets in the city instead of issuing useless notices. This directive can’t work because these are purely commercial buildings,” Mr Mansoor Matovu alias Young, who claims to own 37 buildings in the capital, said.
Mr Godfrey Kirumira, the chairperson of city landlords, wondered why City Hall was in haste to enforce the directive without engaging landlords.

“It’s practically impossible and we have told them to halt implementation because we also have our reasons why we are protesting it. Let them consult us first,” he said.
The landlords’ argument is backed by Dr Amin Tamale Kiggundu, an urban and regional planning scholar, who says that KCCA ought to invest more in public toilets.

“I think this public service is not easy to provide especially in cities of developing countries. Those who are charging a fee are right because they are providing a service which should have been provided by KCCA,” Dr Kiggundu said.
He says that it’s important to foster Pubic Private Partnerships (PPP) whereby government supports investors in constructing many public toilets in the city and pay them some money before they are opened to the public.
Kampala currently has only sixteen public toilets, most located near markets, worship and public open spaces.
Janitors at the facilities do not keep record of users and, as such, precise number of urban dwellers who use the public toilets each day is difficult to compute.
Mr Ismael Lubega, one of the four workers at the Centenary Park public toilet public off Jinja Road, estimates that at least 1,000 people visit the facility each day.
“The numbers keep growing,” he said.

They provide 200 rolls of toilet paper for users every week, costing upwards of Shs100, 000, excluding expenses on water and detergents. This is the kind of anticipated expenditure that landlords are battling to avoid incurring.
Mr Yasiin Ssematimba, the chairperson of Kampala Operational Taxi Stages Association (Kotsa), said that whereas the toilet in the Old Taxi Park was meant to be for free, the owner of the land on which it was constructed took over its management after challenging KCCA in court.

The predecessor of KCCA, then known as Kampala City Council or KCC, was charging fees to access city public toilets. Ms Jennifer Musisi scrapped off the charges in 2012, one year after she became the executive director under the new KCCA Act.
Mr Nasser Ntege Sebaggala, the former Kampala mayor, said that KCC decided to privatise the public toilets because of the budget deficits. Users would part with Shs200 each time one visited a public toilet.

Toilet scarcity effect

Kampala has suffered annual outbreaks of typhoid and cholera and other communicable diseases, all linked to poor sanitation, costing lives and wealth. The dwellers are worried that if the issue of sanitation is not handled well, the situation could worsen.

WHAT THE LAW SAYS...

KCCA ACT. Third Schedule, Part A, of the Kampala Capital City Authority Act, provides, among functions and services for which Kampala Capital City Authority is responsible.
1 (m) public lavatories and urinals; and, (s), sanitary services for the removal and disposal of night soil, rubbish, carcasses of dead animals and all kinds of refuse and effluent;
7(3) The Ministries responsible for health and environment shall oversee the public health and environment matters, respectively, in the capital city.

Locations

City Square
This is a meeting place for many people who usually take a rest in the available open space. It’s also a convergence centre of many taxis which shuttle passengers to different locations.
Nakawa Market
The two toilets at Nakawa Market serve over 3,000 market vendors according to the Nakawa division mayor, Ronald Balimwezo Nsubuga.
Entebbe Road
The public toilet majorly serves passersby, but it also serves vendors from Nakasero market due to its proximity.
Watoto Church
The public toilet on Bombo Road is just opposite an open space where many people gather to take a rest. It’s also used by some people who attend Watoto Church.
Centenary Park
The public toilet in this vicinity is strategically located along Jinja Road, just after the traffic lights. It’s also used by revelers who usually visit the different hangouts in the park.
Usafi Market
The two public toilets in Usafi serve 4000 vendors in the market according statistics from KCCA’s directorate of gender under which markets fall.
Computations
The distances and time between these places were computed by Google.

Residents’ take on public toilets > With Stephen Otage

“It is unfortunate that the public toilets are mismanaged by whoever is mandated to manage them. I would recommend some fee to be levied on usage for purposes of sustainability to keep them clean,” Harriet Komuhimba, Woman Councillor

“I have never used a public toilet for hygiene purposes and I would not recommend anyone to although I pass past many everyday because some people are sick and they do not care about how they dispose off stuff,” Samson.

“They are essential. Unfortunately, I have never used them. I believe they should be paid for because by doing this, the people who keep them are motivated to keep them clean,” Gloria Amutuhire, mental health worker

“I have used them about three times but most of them are in bad shape. Where you are supposed to flush, instead they give you a dirty bucket to scoop water from a drum. The tiles are peeled off,” Edward Isabirye, businessman

“In Uganda, I have not used them but back in Kenya, they are managed by the city council and they are very clean and neat. They charge Ksh20, which is used for buying toilet tissue, water and hand washing soap for users,” Dorcus Odiambo, hotelier

“I have used them once but their hygiene is worrying. Often, you do not find toilet tissue, there is no water and they do not operate for twenty-four hours. Generally, it is not a recommendable place, except for extreme need,” Ali Lukwago, businessman