This is a guest post by Anna Bezruki, an intern for the Council on Foreign Relations Global Health Program. She studies biology at Bryn Mawr College.
According to the final report on Millennium Development Goals (MDGs) released earlier this month, more than a third of the world population (2.4 billion) is still without improved sanitation. The target to halve the global population without adequate toilets by 2015 has not been reached. Consequently, sanitation has been pushed on to the post-2015 sustainable development goals (SDGs). Although India is perhaps the most widely cited failure, accounting for roughly half of open defecation worldwide, it is at least making progress toward the SDG target. The same cannot be said for Nigeria. Lacking the political infrastructure to reform sanitation and faced with security and political concerns that overshadow development goals, Nigeria is struggling to reverse the trend.
Unlike in India, where the percentage of people with access to a toilet shared by only one family increased by eighteen points between 1990 and 2012, that percentage declined in Nigeria from 37 to 28 percent. This incongruity is best illustrated by the fact that there are more than three times as many cell phones in Nigeria as people who have access to adequate toilets. This means thirty-nine million defecate outside, sixteen million more today than in 1990.
Poor sanitation contributes to diarrheal diseases and malnutrition through fecal contamination of food and water. One gram of feces can contain one hundred parasite eggs, one million bacteria, and ten million viruses. Diarrheal diseases kill approximately 121,800 Nigerians, including 87,100 children under the age of five each year. Eighty-eight percent of those deaths are attributed to poor sanitation. Poor sanitation is thought to strain the immune system to the point that permanent stunting and other manifestations of malnutrition can result. More than 40 percent of Nigerian children under the age of five are stunted, and malnutrition is the underlying cause of death in more than 50 percent of the approximately 804,000 deaths annually in the same age range.
The impact of inadequate toilets goes beyond hazardous exposure to feces. A survey conducted by WaterAid, a nonprofit organization focusing on providing safe water and sanitation access, in a Lagos slum revealed that the 69 percent of women and girls without access to toilets are at higher risk of verbal and physical harassment when they relieve themselves.
The effects of poor sanitation are also costing Nigeria economically. The Nigerian Water and Sanitation Program estimates that poor sanitation costs the country at least three billion U.S. dollars each year in lost productivity and health care expenditures. While estimates vary, in 2011, Nigeria invested approximately $550 million, less than 0.1 percent of GDP, on sanitation, a number which has likely decreased since then. This is less than a quarter of the approximately $2.3 billion annually that would have been necessary to meet the MDG target.
It will take more than money and infrastructure to fix Nigeria’s sanitation. Even if investments were to sufficiently rise, the lack of a single government entity with complete responsibility for sanitation within the government, as well as widespread corruption and a lack of community support, would likely hamper efforts. Providing latrines without first creating demand within the community has failed repeatedly, including in India, where latrines have been repurposed for extra storage. There are also other problems, like a treasury emptied by corruption and the war on Boko Haram, that top President Buhari’s agenda. While these are immediate threats that require intense focus, sanitation is an essential long-term investment that will help Nigeria grow.