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World Toilet Day: Many still lack safe toilets, proper sanitation facilities
Author: Jo Barnes
Published: 20/11/2023

​World Toilet Day was observed on 19 November. In an opinion piece for the Mail & Guardian Dr Jo Barnes (Department of Global Health) calls on the government to ensure that all South Africans have access to safe toilets and proper sanitation facilities.

  • ​Read the article below or click here for the piece as published.

Jo Barnes*

During Queen Victoria's reign, there were numerous topics that could not be mentioned in conversation in polite circles. Today that list has shrunk dramatically, but one topic of conversation still elicits uneasiness or else, tasteless jokes – the toilet.

Sanitation is essential for survival. According to the United Nations (UN), 4.2 billion people live without safe sanitation, while 673 million still practise open defecation and 3 billion lack basic handwashing facilities. This sanitation crisis means that untreated or poorly treated human sewage is spreading diseases into water supplies and the food chain for billions of people. This sanitation crisis causes an estimated 432,000 diarrhoeal deaths every year.

The attention to safe toilets has added great advantages that cannot be argued away. Over the past two centuries, safe toilets have added – on average – 20 years to the lifespan of humans.

The UN has announced that, globally, the world is off track to meet Sustainable Development Goal 6 to ensure sanitation and water for all by 2030. Funding is falling short, demand is rising, water pollution is worsening and existing governance structures to deal with these problems are often weak and fragmented. Poor and marginalized people are much more likely to lack safely managed sanitation services and often face many forms of discrimination. They can be left behind as they try to access and manage sanitation services or improve their current facilities with their own meagre resources. Unsurprisingly, the UN's slogan for this year's World Toilet Day (19 November) is "Leaving no one behind".

It is really difficult to obtain reliable data on the state of sanitation service delivery in South Africa. There is an emphasis on water provision and infrastructure, but all aspects of sanitation receive almost no attention and are often simply left out of official reports. That is already an indication of deep structural problems on the part of government.

​The lack of access to water and sanitation has a disproportionate impact on vulnerable groups such as women, children, the aged and people with disabilities. The South African government state does not adopt a human-rights-based approach to service delivery in especially sanitation services and infrastructure. Added to that, there are widespread systemic failures in governance and budgeting, especially in local authority structures  ̶ the very arm of government most directly involved in delivering safe and affordable sanitation to people is failing us on a large scale.

According to the StatsSA General Household Survey, the percentage of households that have access to improved sanitation increased from 61.7% in 2002 to 82.2% in 2017. Despite this improved access to sanitation facilities, many households continue to be without any proper sanitation facilities. Access at an overall level has improved, but that covers a wide variation in service levels with district and local averages, particularly in poor areas, remaining low. Improved also does not mean functioning well –many of these facilities are unreliable or some distance away from the home. This is a great social injustice, giving rise to collective resentment and resulting in unnecessary damage to the local infrastructure that is still working in a manner of speaking.

Fortunately, there is an upsurge of attention to toilet construction in international circles. Toilets on their own however are usually not sufficient to deliver safe sanitation. There is no single ideal toilet design. There can only be a 'best choice' out of a number of options, given the circumstances in a particular setting.

All toilets need some sort of system to deal with the resultant sewage in a safe manner or be connected to a communal treatment system for that purpose. The closer to home or to an individual toilet this treatment process is, the higher the risk that the individuals living on the property will not be willing to do the hard work of maintaining the safe disposal of the sewage. This increases the health risks for the whole community as well as the environment. Communal systems on the other hand often make use of water as a carrier medium and that poses a big problem in our country with its periodic droughts and large arid areas.

What can we do about this? I am concerned that some people in the middle and upper-income groups will try to take over this service on their premises. In some communities where municipal systems have totally collapsed, the inhabitants have started withholding their payment to the municipality, pooling the money and taking over the running of these systems themselves. While that drastically improved the working of such systems, there are legal and operational implications. It also opens the door to withholding services to those who cannot pay, thereby greatly increasing the social injustice aspect.

I wish I had easy solutions to suggest. The best that I can recommend is concerted and serious pressure on the local politicians to improve the operation of our municipalities. The government needs to look very seriously at the accountability and qualifications of the officials entrusted with the running of these systems. If this is ignored, the country will be facing a huge disaster, encompassing both disease outbreaks and upheaval in our communities. The government has been warned and we are waiting.

  • Photo by Point3D Commercial Imaging Ltd at Unsplash

*Dr Jo Barnes is Senior Lecturer Emeritus in the Department of Global Health in the Faculty of Medicine and Health Sciences at Stellenbosch University.