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Africa: We All Need Toilets – Expert Insights Into What Happens When There Aren't Enough of Them

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“Safe toilets for all by 2030” is one of the Sustainable Development Goal targets. But, with just more than five years to go until 2030, the United Nations says the world is “seriously off-track … 3.5 billion people still live without safely managed sanitation, including 419 million who practise open defecation”. That includes millions of people across Africa.
On 19 November each year the UN marks World Toilet Day. In 2024, people’s ability to access safe, hygienic toilets is being disrupted by climate change, war and disaster in parts of the continent affected by flooding, climate-induced migration and conflict. The results: cholera outbreaks, sewage spills, and people continuing to suffer the indignity of going without proper toilets.
The Conversation Africa has published a number of articles explaining the continent’s sanitation problems – and potential solutions. Here are six essential reads.
Africa urgently needs more toilets
The lack of proper toilets in many African countries, including Nigeria, Ethiopia, Niger, the Democratic Republic of Congo, Burkina Faso and Chad, means that many people are forced to defecate outside.
Through no fault of their own, communities run the risk of getting diseases spread by faeces lying around outside. Having no toilets and using outdoor spaces also means that faeces can contaminate water sources. This spreads waterborne sicknesses to humans and livestock throughout the water and food chain.
Recent research by industrial microbiologist Helen Onyeaka and public health microbiologist Omololu Fagunwa found that defecating outside can also lead to antimicrobial resistance. Bacteria that are resistant to medications spread and antibiotics become useless.
Read more: There are too few toilets in Africa and it’s a public health hazard – how to fix the problem
Toilet shortages have led to cholera outbreaks
Over the past ten years, nearly 20 African countries have been affected by dozens of cholera outbreaks. Thousands of people have died of this disease, which can kill within hours unless properly treated. Cholera is spread by Vibrio cholerae bacteria through contaminated water or food in areas with poor sanitation.
Those who live in crowded camps for displaced people, areas hit by floods and urban informal settlements are most at risk, as they often have no access even to communal toilets or clean piped water. The problem, argues microbiologist and infectious diseases researcher Samuel Kariuki, is that governments in Africa make only mediocre attempts to provide clean drinking water and toilet facilities in crowded areas.
Read more: Cholera: how African countries are failing to do even the basics
In South Africa, a cholera outbreak claimed the lives of 47 people in Hammanskraal in 2023. This, after piped water became contaminated with cholera. This year, the country has edged further towards a sanitation-caused public health crisis. Rivers in the country’s industrial heartland province have been flooded with raw sewage by local government authorities following a widespread breakdown of sanitation systems.
Water management expert Anja du Plessis has found that preventing cholera is not a matter of merely encouraging individuals to wash their hands more. Cholera outbreaks will continue to happen unless each person has enough clean water for drinking, bathing, using the toilet, cooking, washing clothes and keeping their home clean. The World Health Organization estimates this bare minimum to be between 50 and 100 litres of person per day.
Read more: Cholera in South Africa: a symptom of two decades of continued sewage pollution and neglect
Nigeria is also plagued by sanitation problems. Many of these stem from outside communal toilets and poor drainage systems, which allow sewage to pile up in the open. Residents in Nigeria’s coastal regions have even told town and urban planner Seun Olowoporoku that the lack of toilets is a bigger problem for them than frequent oil spillage, gas flaring, air and water pollution and agricultural land contamination.
Some of the major concerns of residents surveyed for this research were that disease was spreading from open defecation and that it was not safe for them to walk to toilets built outside their homes.
Read more: Oil hazards aren’t the main worry of Nigeria’s coastal residents: toilets are
How to solve Africa’s toilet problems
Some solutions are on the horizon. But they will require government investment and political will. In South Africa, only 65% of the population have flush toilets, while another 32% use pit toilets. And 30 years of austerity measures mean water and sanitation systems that should have been extended and well maintained to serve a growing population have instead been left to collapse.
Together with drought, the water shortages caused by collapsing systems means it makes more sense for the government to roll out non-sewered sanitation, such as dry toilets, which don’t need to be flushed. Composting toilets are another example of dry toilets that do not flush.
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Water, sanitation and hygiene research scientist Preyan Arumugam-Nanoolal has found that the more research and development is done into safe and clean toilets that do not need water to flush, the cheaper and more advanced these dry toilets will become over time.
Read more: Flushing toilets aren’t the solution to South Africa’s sanitation problem
About 570 million people in sub-Saharan Africa live without proper sanitation. Urine-diverting dry toilets could be one solution, found environmental engineers Mooyoung Han and Shervin Hashemi.
These innovative toilets were designed by the researchers specially for crowded cities where toilets are in short supply. They separate urine and faeces, diverting the two forms of waste into tanks where microbes turn it into fertiliser. This does away with the need for flushing toilets that use water which is not always available and expensive wastewater treatment plants further down the sanitation chain.
Read more: Some smart ideas to make toilets fit for purpose in Africa’s cities
Anna Weekes, Environment + Energy Editor, The Conversation Africa
This article is republished from The Conversation Africa under a Creative Commons license. Read the original article.
Thousands of Khayelitsha Families Use Filthy Toilets or an Open Field
AllAfrica publishes around 500 reports a day from more than 100 news organizations and over 500 other institutions and individuals, representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons. Publishers named above each report are responsible for their own content, which AllAfrica does not have the legal right to edit or correct.
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AllAfrica is a voice of, by and about Africa – aggregating, producing and distributing 500 news and information items daily from over 100 African news organizations and our own reporters to an African and global public. We operate from Cape Town, Dakar, Abuja, Johannesburg, Nairobi and Washington DC.
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Africa: Martin Luther King Jr's Legacy On Health Equity Through the Eyes of a Black African Doctor

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Washington DC — Every year, January 20 is celebrated as Martin Luther King Jr. Day. He was a leader in the Civil Rights Movement who fought for equality and justice, especially for Black people, through peaceful protests and powerful speeches. The day is observed annually on the third Monday of January, close to his birthday on January 15. It is a time to remember his work, reflect on his message of fairness and nonviolence, and engage in acts of service to help others in our communities.
As a global health equity advocate, MLK Day holds special significance for me as a day to remember him as a health equity champion. He rightly identified health inequity as the worst form of social injustice. In his 1966 speech at the Second National Convention of the Medical Committee for Human Rights, MLK stated, “Of all the forms of inequality, injustice in health is the most shocking and inhuman”. I couldn’t agree more.
Globally, health inequities are numerous and mostly preventable. Neglected Tropical Diseases, maternal deaths, and malnutrition vividly reflect the global health injustices MLK foresaw
Growing up in Nigeria as a high school student in the 1980s, I was introduced to MLK through reading editions of Ebony magazine. I remember with nostalgia how I walked to roadside book sellers to buy old copies of the magazine.
These magazines introduced me to Black American social justice debates, including the works of MLK and Thurgood Marshall. It was an opportunity to connect spiritually with Africans in the diaspora – Black Americans – and their struggles. What struck me most as a child was MLK’s nonviolent demand for racial justice.
After high school, I went on to medical school in Nigeria to begin my training as a doctor. By the time I graduated in 1998, it was clear to me that patients’ rights must be respected in healthcare delivery. As health workers, we must prioritize preventive care while providing the care our patients need.
At the time, I did not know the right term for my convictions. Decades into my work in global health, I came to understand the term for my beliefs: health equity. In 2018, I delivered my first TEDx talk titled “Without Health We Have Nothing“. This is why MLK’s assertion that health injustice is the worst form of inequality resonates deeply with me. Healthcare – or its absence – is truly a matter of life and death.
Globally, health inequities are numerous and mostly preventable. Neglected Tropical Diseases, maternal deaths, and malnutrition vividly reflect the global health injustices MLK foresaw.
Neglected Tropical Diseases
Want to see a perfect example of diseases that disproportionately affect poor people? Look no further than Neglected Tropical Diseases (NTDs). These diseases affect 1.6 billion people globally, primarily in Africa and Asia. Many people do not realize some, like those mentioned in the Bible, still exist today.
A prime example is leprosy – a slow-growing bacterial infection that affects the skin, nerves, and sometimes the eyes and nose. Surprisingly, in 2024, the U.S. saw a significant rise in leprosy cases, particularly in the southeastern region, with central Florida identified as a hotspot.
Data reveals that approximately 34% of new cases reported between 2015 and 2020 were locally acquired. Without treatment, leprosy causes numb patches and potential deformities. Fortunately, leprosy is completely curable with antibiotics when caught early.
Other NTDs include river blindness, trachoma, and noma. Noma, in particular, is heartbreaking – it predominantly affects children between and six years who are malnourished, live in unhygienic conditions, or have weak immune systems.
Noma starts as a sore in the mouth but can destroy facial tissues, leaving severe deformities if untreated. Proper hygiene, nutrition, and healthcare can prevent noma, but it remains a reality in the poorest parts of the world.
Maternal Mortality
The United Nations Population Fund (UNFPA) captures the essence of safe motherhood with its statement: “No woman should die while giving life“. Tragically, for many women in low- and middle-income countries, and even wealthier nations, this isn’t the case.
In Nigeria alone, over 80,000 women die annually during pregnancy, childbirth, or shortly afterward. A professor once likened Nigeria’s high maternal mortality to filling a commercial jet with pregnant women every day and letting it crash – a haunting image. This huge injustice should not be allowed to continue.
In contrast, the United States of America has a higher maternal mortality rate compared to other wealthy countries, largely due to the disproportionately high maternal death rate among Black women. Black women are still 2 to 3 times more likely to die from pregnancy and childbirth than White women, regardless of their education level or socioeconomic status.
The solutions to stopping maternal deaths are not rocket science. Prenatal care must identify high-risk pregnancies, and women need access to proper nutrition to reduce the risks of postpartum hemorrhage, the leading cause of maternal deaths. With proper planning and preparation, including access to cesarean sections and emergency services, these deaths are preventable. Addressing these gaps would save countless lives.
Malnutrition
Malnutrition is a double-edged sword – it manifests as undernutrition (not enough nutrients) or overnutrition (eating too much). Both forms can be deadly, especially for children under five. Undernourished children fail to grow properly (wasting) and suffer impaired brain development, leading to stunting.
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Globally, 22% of children are stunted, with 90% of cases occurring in Africa and Asia. On the other hand, overnutrition causes obesity, increasing the risk of non-communicable diseases like diabetes.
The solutions are simple: Support mothers to breastfeed exclusively for six months, educate communities on using affordable, local foods to prepare nutritious meals, and invest in school feeding programs. These steps would dramatically reduce malnutrition’s toll.
MLK’s vision for health justice shapes my global health equity journey. On MLK Day, let us reflect on global health injustices and commit to ending them. Identify one health issue you are passionate about and take meaningful action to address it.
MLK was right – health injustice is the worst form of inequality because without health we have nothing.
Happy MLK Day!
Dr. Ifeanyi M. Nsofor, a public-health physician, global health equity advocate and behavioral-science researcher, serves on the Global Fellows Advisory Board at the Atlantic Institute, Oxford, United Kingdom. You can follow him @Ifeanyi Nsofor, MD on LinkedIn
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Read the original article on IPS.
AllAfrica publishes around 400 reports a day from more than 110 news organizations and over 500 other institutions and individuals, representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons. Publishers named above each report are responsible for their own content, which AllAfrica does not have the legal right to edit or correct.
Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica. To address comments or complaints, please Contact us.
AllAfrica is a voice of, by and about Africa – aggregating, producing and distributing 400 news and information items daily from over 110 African news organizations and our own reporters to an African and global public. We operate from Cape Town, Dakar, Abuja, Johannesburg, Nairobi and Washington DC.
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Africa: Holders Zamalek Lead Star-Studded TotalEnergies Confederation Cup Quarter-Finals

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The TotalEnergies CAF Confederation Cup quarter-final line-up has been finalised with defending champions Zamalek leading a formidable array of clubs into the knock-out stages.
Eight teams from six nations will battle for continental glory when the quarter-finals commence on March 30, with the return legs scheduled for April 6.
Zamalek, who topped Group D with an impressive 14 points, are joined by fellow Egyptian side Al-Masry in the knockout stages.
The White Knights sealed their progress with a convincing 3-1 victory over Nigeria’s Enyimba on Sunday on the final matchday.
Tanzania’s Simba SC emerged as Group A winners, with Algeria’s CS Constantine securing second place.
Morocco’s Renaissance Berkane, previous winners of the competition, topped Group B ahead of South African debutants Stellenbosch.
USM Alger’s dominant Group C campaign saw them accumulate 14 points, while ASEC Mimosas of Cote d’Ivoire dramatically claimed the final quarter-final berth with a convincing victory on the last day.
The quarter-final draw will prevent teams from the same group meeting, meaning Egyptian rivals Zamalek and Al-Masry cannot face each other until at least the semi-finals.
Zamalek will face one of CS Constantine, Stellenbosch, or ASEC Mimosas, while Al-Masry could meet Simba, Berkane, or USM Alger.
The tournament’s knockout phase structure ensures home advantage will be crucial, with group winners hosting the decisive second legs. The semi-finals are scheduled for April 20 and 27, with the two-legged final set for May 17 and 25.
The presence of former champions Zamalek and Berkane, alongside ambitious clubs like Simba and USM Alger, suggests an intriguing battle lies ahead for Africa’s second-tier club crown.
Read the original article on CAF.
AllAfrica publishes around 400 reports a day from more than 110 news organizations and over 500 other institutions and individuals, representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons. Publishers named above each report are responsible for their own content, which AllAfrica does not have the legal right to edit or correct.
Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica. To address comments or complaints, please Contact us.
AllAfrica is a voice of, by and about Africa – aggregating, producing and distributing 400 news and information items daily from over 110 African news organizations and our own reporters to an African and global public. We operate from Cape Town, Dakar, Abuja, Johannesburg, Nairobi and Washington DC.
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ConCourt dismisses bid to block Petauke by-election

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By Hannock Kasama

The Constitutional Court has dismissed the application for a Conservatory Order to halt the PETAUKE Central Constituency by-election.

The application was recently filed by Governance Activist, ISAAC MWANZA and Zambia Civil Liberties Union.

However, the Constitutional Court has ruled that the application by Mr. MWANZA and the Zambia Civil Liberties Union has not outweighed public interest to hold the PETAUKE Central by-election.

Constitutional Court Judge, MATHEWS CHISUNKA has also ruled that Mr. MWANZA and the Zambia Civil Liberties Union have not demonstrated any prejudice they would suffer on account of the holding of the PETAUKE Central by-election.

Mr. MWANZA and the Zambia Civil Liberties Union had filed a petition in the Constitutional Court challenging the constitutionality of National Assembly Speaker NELLY MUTTI’s declaration of the PETAUKE Central seat vacant.

The post ConCourt dismisses bid to block Petauke by-election appeared first on ZNBC-Just for you.

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