Togo: Using toilets to fight cholera

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Located 350 kilometres north of Lomé, Sokodé, the second-largest city in Togo, was the epicentre of three cholera outbreaks in 2013. That same year, the African Development Bank made a €1.15 million grant to the city through the African Water Facility, to fund the "Toilets for All in Sokodé" project. There have been no outbreaks of cholera in Sokodé since then.

The Bank is the main donor to this €1.545 million project, alongside €210,000 contribution by Plan International Togo, the remainder being funded by the city and residents themselves.

"It was two in the morning one night when I needed to go and relieve myself. But the public latrines were a long way from my home," recalls Zalia Zoukoufoulou, who lives in Sokodé where only 34% of households had their own toilets in 2013 – before the launch of the project. Zalia's anecdote reveals how hard it is for large numbers of the city's residents to live in satisfactory sanitary and hygiene conditions.

The 100,500 or so inhabitants of Sokodé were faced with the difficulties that arise from lack of latrines and toilets: lack of privacy, insecurity – especially for women – and hygiene and public health problems. Only 34% of Sokodé households had their own toilets in 2013 before the launch of the project. Another resident, Lougma Traoré, explained that he used to "dispose of his children's toilet waste in the natural environment." Open defecation and a lack of dedicated toilet facilities are conducive to the spread of various diseases, and these are not minor bugs, but life-threatening diarrhoea and cholera.

Putting an end to uncontrolled toilet waste disposal

How can this toilet waste, called faecal sludge, best be managed in the absence of a sanitation network worthy of the name? "Most of the sludge trucks to come from Lomé, and this meant that the service was quite expensive for households. So, we used to resort to disposal by hand and households would drop their human waste in the city's watercourses or on the market gardeners' fields," said the city's mayor, Alassane Tchakpedeou. "Our city was known for being ontop of the cholera league. As soon as each year's rains came, Sokodé would have a cholera outbreak; Sokodé suffered faecal risk," he continued.

Extended to 30 September 2018, the "Toilets for all in Sokodé through waste treatment of faecal sludge and microcredit" project enabled the construction of 788 latrines for the benefit of those living in seven of the city's neighbourhoods and the neighbouring municipalities of Tchamba, Sotouba, Bassar, Bafilo and Blitta. Neighbourhood Sanitation Committees (CAQs) were set up to ensure the sustainability of the project's achievements and to continue to raise residents' awareness and encourage them to join the list of project beneficiaries and reduce open defecation.

Microcredit and awareness-raising multiplier effect

To enable the largest-possible number of inhabitants to equip their homes with toilets, the budget was carefully planned so that beneficiaries only had to find one quarter of the cost and a microcredit system was set up to help them settle their share. "It costs 400,000 CFA francs (US$800) to build a latrine and the project accounted for 300,000 CFA francs (about US$600) of the cost. Beneficiaries contributed 100,000 CFA francs (about US$200)," said CAQ coordinator Adiétou Katakpaou, adding, "We have a register of repayments that are made gradually. The money collected is banked so that others too may benefit from the project." The CAQs keep account books to record and monitor beneficiaries' instalmental repayments. The money collected in this way is used to fund the construction of new latrines.

"The project has acquired a faecal sludge transport truck for the city of Sokodé," said project coordinator, Tetouehaki Tchonda. "For areas that are relatively hard to access by lorry, a mini-transport system consisting of a tricycle, a power-operated pump and 100-litre sludge containers has been acquired.

Collection, treatment and valorization of faecal sludge

Once it has been collected, the faecal sludge from latrines is conveyed to the new treatment plant – opened in late June 2018 – to reduce the health and environmental risks associated with human waste. With a capacity of 6,400 cubic metres, the plant has three simple drying beds and a scraped sludge drying area. Bio-solid materials from the waste treatment are then made available to market gardeners and farmers. In this way, the project makes helps to fertilise the soil and consequently promotes food security.

Another positive outcome is the seven community-based micro-enterprises in Sokodé – in which women account for more than 45% of the workforce – that have benefited from capacity building.

To ensure that beneficiaries took maximum ownership of the project and fully bought into it, the African Development Bank undertook "a lengthy piece of social preparation work," explained project manager and African Development Bank sanitation expert Ousseynou Guene. Ousseynou continued, "We used a participatory approach within the various community organizations.

The city that was once a centre for the spread of cholera in Togo is now a benchmark for sanitation," he said with obvious pleasure. It is the only city in the country endowed with a human waste treatment plant and where community organizations have turned into service provision enterprises."

Since the beginning of its operations in Togo in 1972, the African Development Bank Group has approved a total of 76 operations with a cumulative value of US$538.24 million.

As of August 2018, the Bank's portfolio in Togo included 13 operations amounting toUS$297.80 million in cumulative net commitments. Ten of these operations are national in scope, totalling US$143.94 million of investment (32% of the total envelope) and three others are multinational, accounting for US$153.86 million (68%).

The sectoral distribution of the portfolio reflects the predominance of transport infrastructure (75.55%), followed by economic and financial governance (13.88%) and the social sector (8.77%). Agriculture, water and sanitation, energy and the financial sector represent approximately 0.6% each.

Toilets for all:

The Ethekwini Declaration was signed in February 2008 in South Africa. In this declaration, 32 African governments recognized the importance of sanitation and committed to dedicating 0.5% of their national GDPs to it.Ten years later, it is clear that this commitment is still wishful thinking. In addition, the 2014 joint World Health Organization (WHO) and UNICEF report, called for an urgent response. The statistics showed that nearly half of the population of Africa had no access to toilets. In 2012, 39 million people in Nigeria had no choice but to use open defecation (against 23 million in 1990). Similarly, 34 million in Ethiopia, 17 million in Sudan and 10 million in Mozambique do not have access to latrines.Nonetheless, some countries have made considerable efforts. One of these is Ethiopia. On the basis of collaborative work between the ministries responsible for sanitation, quality of life, housing and civil society, the open defecation rate fell from 92% in 1990 to 37% in 2012. In Rwanda, provision of drinking water supply to a large part of the population (85%) and of sanitation for 65% of homes has helped the country achieve the lowest open-defecation rate in Sub-Saharan Africa, at 2.99% according to WHO and UNICEF.Lack of access to sanitation exposes many African countries to water-borne diseases. Every year, hepatitis, polio, dysentery, diarrhoea and cholera result in 760,000 deaths among children aged below five worldwide, according to the WHO.