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Wiping open defecation cut cholera, created jobs

Health & Science

A SATO toilet bowl in Bar Agulu village, Siaya County. [Denish Ochieng, Standard]

Mary Achieng walks shoulder-high at her home in Baragulu village, Siaya County. Her family of seven has not suffered any sanitation-related illnesses in five months thanks to a pan placed on her pit latrine.

The Safe Toilets (SATO) are mechanical with air-tight seals that close off latrines and thus keeping away insects which spread diseases after coming into contact with human waste.

Use of SATO pans helped reduce open defecation and has enhanced sanitation levels in Siaya, Homa Bay and counties in Nyanza where previously “we had frequent diarrhea but since all has been well,” says Achieng.

Besides sanitation, the toilets have come in handy for James Odhiambo who was disabled during the 2007 post- election violence from which he has undergone several surgeries on his hip joint, back and he also experiences numbness below the knee of his right leg.

A SATO stool has made life easier as going to the toilet is no longer a problem as “it is clean and serves me well.” 

The sanitation project has been a joint effort between UNICEF and the county governments with Siaya achieving Open Defecation Free status in 2018 and has since launched market-based sanitation activities to upgrade sanitation which includes construction of low-cost improved sanitation systems installed in markets, schools, public toilets and churches.

Siaya County has installed 24,115 latrines –enabling more than 120,000 people to access basic sanitation courtesy of UNICEF accelerating the elimination of Open Defecation and facilitating access to basic sanitation in communities and schools. 

Siaya County public health officer George Ougo pegs latrine coverage at 92 percent.

The project is supported by the Government of Japan through the ‘Emergency Assistance for Prevention of Further Spread of [Covid-19] in Africa through Partnerships with the Japanese Private Sector’ initiative.


Use of SATO pans helped reduce open defecation and has enhanced sanitation levels in Nyanza. [Denish Ochieng, Standard]

The sanitation project sees vulnerable households access financing to upgrade their basic sanitation while providing employment and entrepreneurship to members of the community. For instance, some 130 artisans were equipped with skills to build low –cost toilets.

 Siaya County had been grappling with at least two incidences of cholera outbreak leading to the loss of lives since 2016, the year 558  cases of cholera left 15 dead with the most affected sub-counties being Alego Usonga, Ugunja and Ugenya.

There were 1,117 cases of diarrhea in December last year down from 2,177 that November 2020.

Now, however, diarrhea cases have been declining since June last year and no single case has been reported this year, according to data from the Siaya Department of Health and Sanitation.

UNICEF is also working to improve sanitation in Homa Bay with the project covering the sub-counties of Rangwe (359 villages), Homa Bay Township (266) and Kasipul (293) and 30 schools with the aim of being Open Defecation Free.

In Kisumu, about 60 percent of villages are open defecation-free after the county began implementing community-led total sanitation strategy which has seen latrine coverage stand at 96.3 percent up from 80.1 percent since 2014, according to Kenya National Bureau of Statistics 2019 Census Report.

The strategy has since stopped recurrent cholera outbreaks in both urban and rural areas via improved clean water supply and safely managed sanitation services.

Only 3.6 percent of households in Kisumu are practicing open defecation and still “85 percent of Open Defecation takes place in 15 counties,” including Homa Bay said Unicef Kisumu chief field office, Wangui Karanja but she hopes the project aims “to eliminate Open Defecation in 15 counties by 2025.”

The county and Unicef introduced Market-based Sanitation (MBS) and Open Defecation that stood at 38 percent in 2015 had been reduced to less than 10 percent, according to Homa Bay County director and Water Sanitation and Hygiene (WASH) Partner Coordinator, Mark Aguanda.

“Three sub-counties Ndiwa, Homa Bay and Kasipul, have become Open Defecation Free zones,” Aguanda said adding that a drive had been launched for building modern latrines with the focus being on schools.

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