Commentary

99% of Sierra Leoneans welcome President Bio’s reintroduction of the National Monthly Cleaning Saturday as a big boost to human health and the environment. Now many say the focus should include improving sanitation.

“The focus on sanitation is fundamental to human beings,” says Pasquale Steduto, UN-Water chairman. Adequate sanitation, together with good hygiene and safe water, are fundamental to good health and to social and economic development. That is why, in 2008, the Prime Minister of India quoted Mahatma Gandhi who said in 1923, “sanitation is more important than independence”.
Improvements in one or more of these three components of good health can substantially reduce the rates of morbidity and the severity of various diseases and improve the quality of life of huge numbers of people, particularly children.
Many urban Sierra Leoneans do not have access to proper toilet – that is, a proper toilet which separates human waste from human contact. Those who live without access to a toilet at home are vulnerable to a range of health risks.
WHO Director-General Dr Margaret Chan noted that, "Sanitation is a cornerstone of public health. Improved sanitation contributes enormously to human health and well-being, especially for girls and women. We know that simple, achievable interventions can reduce the risk of contracting diarrhoeal disease by a third." “The absence of adequate sanitation has a serious impact on health and social development, especially for children. Investments in improving sanitation will accelerate progress towards the SDGs and save lives. In particularly Freetown, hundreds of thousands of slum dwellers have no toilets at home. If current trends continue, the children among them will continue to pay the price in lost lives, missed schooling, in disease, malnutrition and poverty.
Using proper toilets and hand washing - preferably with soap - prevents the transfer of bacteria, viruses and parasites found in human excreta which otherwise contaminate water resources, soil and food. This contamination is a major cause of diarrhoea, the second biggest killer of children in developing countries, and leads to other major diseases such as cholera, schistosomiasis, and trachoma.
Thus, improving access to sanitation is a critical step towards reducing the impact of these diseases. It also helps create physical environments that enhance safety, dignity and self-esteem. Safety issues are particularly important for women and children.
Also, improving sanitation facilities and promoting hygiene in schools benefits both learning and the health of children. Child-friendly schools that offer private and separate toilets for boys and girls, as well as facilities for hand washing with soap, are better equipped to attract and retain students, especially girls. Where such facilities are not available, girls are often withdrawn from school when they reach puberty.
In health-care facilities, safe disposal of human waste of patients, staff and visitors is an essential environmental health measure. This intervention can contribute to the reduction of the transmission of health-care associated infections.