A toilet in Magumoni, Chuka. [Olivia Murithi, Standard]

There are 15 counties in Kenya where you will spend hours on end searching for a washroom, with the ‘open-air toilet’ being your last resort.

Such lack of decent places to answer calls of nature contributes to the spread of diseases like cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio. In February, six polio cases were confirmed from sewage samples in Garissa and Mombasa counties.

Turkana County has more than half the population relieving themselves in the open followed by Samburu, Tana River, Marsabit and Wajir, according to the 2019 census.

Nyeri County has the most toilets per person with only 0.1 per cent of the population using open defecation as opposed to Turkana (68.1 per cent), Samburu (65.6) and Tana River at 48.6.

The 2019 Census revealed that 7.4 per cent of Kenyan households lack sanitation, with around 10 per cent of the population or 4.7 million people practicing open defecation. This is common in rural areas (11.5 per cent) and urban areas (0.8 per cent), with Kibra slums leading with its (in)famous ‘flying toilets’ in Nairobi.

Steven Kamau, a Kibra resident, says the main options are communal toilets or open defecation and while “there’s a toilet that we pay to use, most times we just find a corner to relieve ourselves for short calls. The biggest challenge is always the long call” and most people pay to use toilets mostly during outbreak of cholera when they also resume washing hands more often, adds Kamau who moved to Kibra four years ago.

Mercyline Adhiambo mostly uses a pit latrine at night as during the day “I just dig a hole, relieve myself then continue with my work at the shamba.”

The sanitation challenges in most counties in Kenya saw Unicef Kenya and the Ministry of Health launch the Kenya Sanitation Week (KSW) targeting Garissa, Homa Bay, Kilifi, Narok, Turkana and West Pokot to raise awareness on the need to end open defecation.

“We are mobilising communities to participate in cleaning the environment and using proper methods of hand washing which have been proven to prevent the pandemic,” said Janet Mule, Principal Public Health Officer, WASH Divison, Ministry of Health.

Of the 15 counties, Mule lists Tana River (48.6 per cent), Garissa (36.2), Isiolo (30.6) and Homa Bay County at 10 per cent as places where people practice open defecation.