Increased sewerage coverage remains a pipe dream

Unhygienic. A woman walks along a trench lined with pit-latrines in Kawempe Division last year. Many pit-latrines in Kampala are mostly unlined, contain a large amount of solid waste, and are difficult to access for emptying. MONITOR PHOTO.

What you need to know:

  • Poor sanitation. Figures from the Ministry of Health indicate that 75 per cent of the diseases that afflict Ugandans most are directly linked to lack of water and proper sanitation facilities. The most common diseases are diarrhoea, dysentery, typhoid, and cholera.
  • Deadly. The national integrated comprehensive prevention and control plan of the Ministry of Health indicates that there were 324 cases of cholera and seven related deaths in Kampala in the period between 2011 and 2016.

The promise:
One of the things that the ruling NRM committed itself to do in the run-up to the 2011 General Election was to address what it termed as “the critical challenges facing the urban areas”. The party particularly committed itself to increasing safe water supply and sewerage coverage.
“In the next five years, the NRM will…expand the piped water sewerage services in Kampala from the current level of 7 per cent to 30 per cent,” the manifesto reads in part.

The manifesto indicated increment of the sewerage services in the city would be done through the implementation of the €68 million (Shs289b) Kampala Sanitation Project (KSP) funded by the African Development Bank (AfDB).

KSP was mooted amid an increase in the number of people residing in Kampala city, which resulted into a sharp increase in demand for water and sewerage services. That demand resulted into increased pressure on water sources and heavy pollution of the water bodies.
The project was planned to improve the sewerage situation in the city by, among other things, the rehabilitation and extension of the sewerage network, improving the collection and treatment facilities for faecal sludge and waste water.

The project was meant to protect the quality of water in the inner Murchison Bay area of Lake Victoria.
Phase One of the project, which was meant to be implemented in the first four years, entailed expanding waste water and sludge treatment capacities, raising public awareness about improved sanitation and hygiene and improved management of the waste management services.

Health risk. Sewerage flows out of Kirudu Hospital in Makindye Division in May. This was partly blamed on poor sewerage system, which resulted into an overflow. PHOTO BY ALEX ESAGALA.


Those who were meant to directly benefit from the programme were Kampala’s population of 1.4 million and people resident near or along the shores of Lake Victoria.

The beneficiaries had been targeted for participation in activities that had been planned for improvement of sanitation and hygiene that had been lined up to be conducted in the city, while health and education facilities and those resident in low market areas were earmarked to participate in onsite sanitation and hygiene campaigns.
Residents of the low end parts of the city were meant to be trained and assisted in the construction of their own onsite sanitation facilities and how to improve their personal hygiene.

Interventions made under KSP were expected to lead to across the board improvements in public health, lead to a sharp drop in the number of water and sanitation-related diseases and major improvements in environment and eco-system around the parts of Lake Victoria that are close to the city.
Ordinarily, KSP was meant to have been implemented beginning in July 2008 and 2022, but it did not start as planned due to delays in getting the necessary approvals for the loan from Cabinet, Parliament and the Attorney General.

Even when the approvals had been got, AfDB approved the loan facility in December 2008, but it was not until May 2009 that an agreement was signed. That, however, did not mean that it became active with immediate effect. It was not until February 2010 that it did.
When the challenges around the finances were finally done away with, implementation was delayed because of alterations to the initial designs of some of the waste treatment plants and legal battles over the land on which the plants were meant to be located.
As a result, the promise to increase piped sewerage coverage for Kampala by 23 percentage points was never and has never been realised.

Impact
According to the Water and Environment Sector Performance Report 2017, whereas 99 per cent of Kampala’s population has access to some form of sanitation facility, 90 per cent of them rely on onsite sanitation facilities, which are not classified as “improved” or “acceptable”. Only 9 per cent have access to the public piped sewerage network.

“More than 50 per cent of toilets are shared by multiple households, leading to unhygienic conditions. Pit-latrines are mostly unlined, contain a large amount of solid waste, and are difficult to access for emptying, ultimately resulting in filled pits that are either abandoned or directly emptied into the environment, posing health and environmental risks for the city and its people,” the report reads in part.

Figures from the Ministry of Health indicate that 75 per cent of the diseases that afflict Ugandans most are directly linked to lack of water and proper sanitation facilities. The most common diseases are diarrhoea, dysentery, typhoid, and cholera.
The national integrated comprehensive prevention and control plan of the Ministry of Health indicates that there were 324 cases of cholera and seven related deaths in Kampala in the period between 2011 and 2016.

Improved access to sanitation facilities has been interpreted to mean improvements in personal hygiene and cleanliness of toilets, but handling of faecal sludge from the on site facilities remains a big challenge.
It is estimated that 43 per cent of the faecal waste generated daily in Kampala is currently emptied from the pit-latrines and safely managed”.
A sanitation census carried out in the city revealed that 96 per cent of the city’s residents who are not connected to the public piped sewerage network use cesspool trucks to empty the on site facilities, while others use manual and semi mechanised methods to get faecal sludge.

At the same time, it is believed that about 5 per cent of the population in Kampala practice open defecation, while 38 per cent have latrines that cannot be drained using cesspool emptiers. This often results into faecal sludge finding its way into drains and roads whenever the rains come, making the contamination of food and water possible. This translates into diseases. It is a situation that could be mitigated by increasing the coverage of piped sewerage.

Matters are not helped by the fact that a huge percentage of Ugandans do not wash their hands after visiting the toilets. The minister for Water and Environment, Prof Ephraim Kamuntu, told the gathering during last year’s launch of the water and sanitation loan facility that only 29 per cent of Ugandans wash their hands after visiting the toilets, adding that “the rest walk away.

Nakivubo channel

Others defecate in the open and that discharge is washed into water sources. Those with pit-latrines do not have toilet paper. They use their hands and after coming out, they want to greet you”.
A huge percentage of those who do not wash their hands are residents of Kampala. Little wonder that the food borne diseases such as dysentery have also been on the rise in the city.

Official Position

The National Water and Sewerage Corporation spokesperson, Mr Sameul Apedel (pictured above), said whereas Kampala’s central business district and the older parts of Kampala, which were constructed by the colonialists, are 100 per cent covered, the other parts of the city remain heavily reliant on onsite sanitation facilities.
“Right now, piped sewerage coverage is still at around 10 per cent. We are working on the Bugolobi plant, which will treat 45 million litres of waste water. We are also working on a sewerage treatment plant at Kinawattaka and creating a sewerage network of 32kms. If that is done, along with other planned treatment facilities in Kajjansi and Nalukolongo, piped sewerage coverage will increase to around 30 per cent,” he said.

Monitor’s position
Expanding the piped sewerage network to cover the entire Greater Kampala Metropolitan Area is always going to be a very difficult enterprises. It requires colossal sums of money.
Whatever NWSC has been doing in extending piped water and putting in place the appropriate sewerage infrastructure has only been happening with donor support. With Bank of Uganda having put the provisional total public debt stock (at nominal value) as at end of December 2017 at Shs37.9 trillion, it might not be feasible for the country to continue borrowing in the name of expanding the piped sewerage network.
However, it does not mean that we sit back, fold our hands and do nothing to address the sanitation and health challenges that Kampala is faced with.

Government could start by introducing a subsidies regime for items that could help the population around Kampala put up improved sanitation facilities that can be emptied by cesspool emptier and the faecal sludge moved to proper waste treatment facilities.
The policy should include the encouragement of all commercial banks to boost this initiative by introducing water and sanitation facility loans. Post Bank is already doing so, but others should be encouraged to join it.