a pit toilet: John's neighbors allowed the tenants to use until they could no longer manage the number of people visiting the 5 fit deep toilet in a day.


By Ndidichukwu Odoh

John Dickson ‘landlord’ constructed toilet in his 20 year-old house for the first time in August 2019, after Community Implementers of UNICEF’s supported Mass Administration of Medicines for prevention of Neglected Tropical Diseases visited.

Ten families, comprising children, nursing mothers and pregnant women live in John’s compound and pay annual rent, despite the absence of a toilet for his tenants.

“There was no toilet in the compound, we were defecating in the bush, because the ‘landlord’ did not want to construct toilets for us until the health people came” said Mr. James Uka, a tenant.

After sensitization, the tenants are now aware of the health hazards caused by open defecation in their community

The Neighbors who allowed John’s tenant share their toilet, got tired of the number of people who visited and had to shut their doors, when the pit toilet was almost filled.

Prior to the visit of health workers during the MAM exercise John’s tenants were known in the community as one of those responsible for open defecation practices and poor excreta disposal.

“Diarrhea diseases kept coming back after children were treated” said Maryann a nursing mother and one of the tenants.

Between June and August, five children below the age of five have had diarrhea and had to sleep in the hospital.

In August when UNICEF trained Community Implementer for MAM, Esther Benjamin visited John’s compound, she sensitized the women on the effects of open defecation, while she administered Albendazole and Mectizan for Prevention of Tropical diseases like lymphatic Filariasis also known as Elephantiasis and Onchocerciasis otherwise called River Blindness.

UNICEF trained Community Implementer of MAM, administer Mectizan and Albendazole to communities in Rivers State

Onchocerciasis, is a parasitic disease caused by small worms living in the body. It is transmitted by the bite of a black fly which is a vector for River Blindness, While Lymphatic Filariasis happens when a female mosquito bites an infected person to take blood, baby worms under the infected person’s skin are transferred to the mosquito. When the mosquito bites another person, the baby worms are injected into the skin. The baby worms block the blood stream and cause swelling in the legs and scrotum.

In Nigeria, Onchocerciasis is endemic in 32 states and the FCT, only three states-Plateau, Nasarawa and Kaduna out of 36 and FCT have interrupted Onchocerciasis, but Lymphatic Filariasis remains endemic. The MAM community implementers sensitized Rivers communities on sanitation and against open defecation practices, to prevent spread of the diseases.

UNICEF is integrating NTDs into WASh, MAM monitors also sensitized Nigerian Communities on Sanitation and Hygiene

“As a result of the sensitization, I and my tenants contributed money to construct toilets for each household in the compound, now the children are discouraged against open defecation.  My tenants are now more health conscious than they were before the health workers visited” Said John.

While UNICEF is supporting the administration of preventive medicines for Elephantiasis and River blindness, households visited in the first phase of the MAM were also educated about Water, Sanitation and Hygiene.

“As UNICEF supports communities to prevent tropical diseases, we are integrating sensitization for water, sanitation and Hygiene, we educate and create awareness to households visited on the importance of proper hygiene by discouraging open defecation and improper sewage disposal” said Chioma Mong, a UNICEF national monitor for NTDs in WASH.

Chioma Mong, UNICEF national monitor for NTDs in WASH

“Rivers state is endemic for NTDs, before we commenced MAM, we did sensitization in churches, and we used town criers, visited schools and market places. We ensured that mobilization was effectively done, we also utilized the opportunity to educate different households about the effects of open defecation” said Promise Komenewane, Rivers State Neglected Tropical Disease (NTD) Coordinator.

In NTD programme with proper mobilization, 100% geographical coverage and a minimum of 65% Therapeutic coverage are achieved.  Targets are reached in most of the LGAs and the response has been impressive. John’s compound was one out of many in Omuanwa community in Ikwere Local Government without toilets. There is still high level of open defecation in  communities in Rivers State. Mass sensitization programme is required to reduce the high open defecation practices, prevent the spread of diseases and harmful practices that affect children in the State.