In this report, Royal Ibeh examines how open defecation is fueling Neglected Tropical Diseases at Alaba Home of Destitute, Alaba Rago area in Ojo Local Government Area of Lagos state.
Behind the popular Alaba International Market, Lagos state, lies Alaba Home of Destitute, a community barely known to the majority, which stands as a glaring example of urban decay where hope is overshadowed by the harsh realities of poverty.
Alaba Home of Destitute offers no comfort, no warmth during the cold nights, and no shade during the scorching days. Yet, it is home for about 2000 people-a place where a beggar and leper, Abdulahi Umar, his wife, and their eight children huddle together to survive the harsh realities of their existence.
At 60, Umar is a beggar by circumstance, not by choice. His body bears the scars of leprosy, a disease that has claimed much of his physical mobility and rendered him incapable of working in a conventional sense. But his spirit remains unbroken.
Every day, Umar makes his way to the bustling streets of Lagos, dragging his frail body through the crowds, hoping for the generosity of strangers. His hands, deformed by the disease, are held out in silent plea as he watches passersby with a mixture of hope and desperation.
“I never wanted this life,” Umar confessed, “But what choice do I have? I need to feed my children, I need to survive.”
Umar and his family have lived in a house made with roofing zinc for over three decades. The zinc tremble with each gust of wind, and when the rainy season comes, they are powerless against the floods that often seep in.
But the structure is the least of their worries. Their community has no access to basic amenities. There are no toilets, no clean water, and no healthcare services. Open defecation is a norm here, and the stagnant air around their home is thick with the odor of waste and decay.
The Umar family, like their neighbors, must make do with whatever resources they can find, but it is a constant struggle to keep their environment even remotely clean.
“We live like animals,” Umar says with quiet resignation. “But we are human beings, too.”
Worst still, open defecation and squalid living conditions have created a breeding ground for Neglected Tropical Diseases (NTDs), pushing an already vulnerable population further into the shadows of neglect.
Nexus between open defecation and NTDs
The Alaba Home of Destitute, originally established as a refuge for the city’s most destitute populations—beggars, displaced individuals, and the homeless—has over time transformed into a community of extreme poverty. While the residents struggle to eke out a living, their daily realities include navigating a lack of clean water, inadequate sanitation, and an overwhelming absence of proper healthcare services.
The situation can allow NTDS, a group of bacterial and parasitic infections that thrive in conditions of poor hygiene and poverty, to proliferate if unchecked, the United Nations Children’s Fund (UNICEF), Water Sanitation and Hygiene (WASH) specialist, South-west zone, Mr Monday Johnson told DNN News.
Diseases such as soil-transmitted helminth infections, schistosomiasis, trachoma, and lymphatic filariasis are not just endemic; they flourish in the unhealthy conditions created by poor sanitation practices, most notably open defecation, he affirmed.
He defined open defecation as a practice of relieving oneself outdoors without any form of toilet, adding that it is a major public health issue in Nigeria. Latest report by WASH National Routine Mapping (WASHNORM), showed that 47 million people in Nigeria practice open defecation with only 18 per cent of Nigerians (37 million people) having access to safely managed sanitation services.
“In places like the Alaba Home of Destitute, where there are no toilet, it is an unfortunate necessity. Human waste accumulates in the environment, contaminating water sources, spreading infectious agents, and creating an ideal habitat for the transmission of NTDs. Parasitic worms and other disease-causing organisms thrive in the contaminated environment, easily entering the bodies of children and adults through contact with contaminated soil, water, and food. Once inside the body, these pathogens can cause debilitating illness, further weakening an already fragile population. Children, often the most vulnerable in such environments, are also disproportionately affected. NTDs can cause severe malnutrition, stunted growth, and cognitive impairment,” Johnson explained.
“Just take a look at us. Some of us are blind, leper and our children are always falling ill of cholera. We just had an episode of cholera few months ago. We had to beg doctors to come to our aid. Many of our children show signs of poor health because we don’t have money to feed them well. Sometimes we don’t eat in a day,” Umar averred.
For the residents of Alaba Home of Destitute, living with the daily threat of disease is a grim reality. The Imam of Alaba Home of Destitute, Rabiu Maurudi, who has lived in the community for over three decades, shared his ordeal. “We have no choice but to defecate at the canal at the back of our home. There are no toilets, and the stench is unbearable. We have a well, but the water is yellowish. Though a politician constructed a borehole for us as you can see, we don’t have the financial muscle to buy fuel to bump water. So, all of us had to fall back to the dirty water, which we use for drinking, cooking and washing clothes.”
Lagos state government reacts
The Commissioner for Information and Strategy, Mr. Gbenga Omotoso, told DNN News that the Lagos state government is implementing strategies to eradicate open defecation, adding that plans are underway to provide more public toilets across the state to stop open defecation.
“We have all kinds of people trooping into Lagos daily, and open defecation is very common as a result. Very soon, we will see brand new public toilets all around Lagos”, he said.
When asked if this initiative will be extended to the Alaba Home of Destitute, Omotoso said, the state is in the processing of mapping areas where the public toilets will be situated, adding that he will keep in mind Alaba Home of Destitute.
Urgent need for change
To address the crisis, UNICEF and other stakeholders, including government agencies, private sector, civil society groups and celebrities, are ramping up efforts to end open defecation by 2030. The initiative involves the construction of proper sanitation facilities in both urban and rural communities, hygiene education programs, and community engagement to change the long-standing practices.
The director of Water Quality, Sanitation, and Hygiene at the Federal Ministry of Water Resources and Sanitation (FMWRS), Mrs. Elizabeth Ugoh said despite efforts to attain open defecation-free status, only 126 local governments out of 774 have achieved this goal. Ugoh emphasized the need for increased investment, improved infrastructure, and stronger partnerships to address these challenges, while calling on the private sector to play a more active role in supporting sanitation initiatives.
UNICEF Nigeria chief of Water, Sanitation and Hygiene (WASH), Dr Jane Bevan said with an estimated 47 million people lacking access to toilets, Nigeria remains one of the world’s worst offenders for open defecation. To end the menace, Bevan said the government cannot solve this problem alone, while calling for a multi-faceted approach that includes the private sector. “There is need for private businesses to invest in public toilets, particularly in urban areas like Lagos,” she added.
The director general, Lagos Chamber of Commerce and Industry (LCCI), Dr Chinyere Almona, noted that over 47 million people in Nigeria still practice open defecation, contributing to a staggering annual loss of $1.5 billion due to health-related issues and reduced productivity. Investing in improved sanitation not only addresses these critical health concerns but also promises substantial economic returns, Almona said, while citing studies that showed a significant return on investment in sanitation, with potential economic benefits of up to $5.50 for every $1 spent.
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