Nairobi/Kisumu — The odour of human waste is unbearable at the pit latrine behind Nancy Anyango's house in Manyatta, a sprawling slum in the western city of Kisumu. Nearby, a heap of rotting garbage lies between long rows of shanties. From a distance, one can hear the flies buzzing.
The open pits exacerbate the threat of disease. They are also a physical risk for children. Only a couple of months ago, Anyango lost her three-year-old son when he fell into one of them while playing with other kids.
"The waste produces a pungent smell, and when it rains, it floods our houses, and we are forced to move out. The lives of our children, too, are in danger because they play inside the filth," Anyango told IRIN.
Risks to residents
Local government authorities put the slum's population at 45,000, but they are served by no more than 30 pit latrines. And because people are charged a fee to use the latrines, many opt defecate in the open instead.
"Somebody living in a slum and very poor like I am must make a choice. I can't use 10 Kenya shillings (US$0.12) to pay for a toilet every day when that can buy me a jerrycan of water for bathing and washing my clothes," Walter Opicha, a resident, said.
In Kibera, arguably the country's largest slum, situated in the capital, Nairobi, open sewer lines empty effluence in front of people's houses. Defecating into polythene bags, then disposing the bag haphazardly, is common; sometimes the bags, known as "flying toilets", are simply flung into the distance.
Kibera is home to 170,000 people, according to the 2009 census. But according to the Nairobi City Council, it only has 1,000 public toilets.
Many NGOs are working to construct latrines - by March 2012, the NGO Sanergy had constructed some 20 community pit latrines in Kenyan slums - but these efforts are dwarfed by the scale of the need.
According to Amnesty International each pit latrine in Nairobi's slums is shared by between 50 and 150 people. For women, attempting to use the latrines at night exacerbates the risk of rape.
"These toilets they are building are few, and Kibera has so many people in it. People still relieve themselves in the open air and in polythene bags inside their houses and throw them away. At times, they just land on other people's roofs," Allan Obonyo, a resident, told IRIN.
"Even if you wanted to use these toilets, you can't at night because you will be beaten by thugs, and for women, you can be raped," he added.
Poor sanitation contributes to diarrhoea, an illness that kills one in five children in Africa.
In Kibera, the prevalence of diarrhoea among children under age three is 40 percent, according to the African Population and Health Research Centre, more than three times higher than rest of the city.
Access to clean water is also insufficient. According to the 2009 census, just 38 percent of Kenya's urban areas have access to piped water.
Yet these conditions are ubiquitous. About 60 to 80 percent of Kenya's urban population lives in slums. In Nairobi, informal settlements cover just 6 percent of the total residential land area, yet house 60 percent of the city's population.
Growing urban populations and lack of proper planning by the government are largely to blame, analysts say.
"People are migrating to urban centres in search of jobs. This consequently piles pressure on already strained infrastructure, including residential areas, and the government is caught flat-footed and appears helpless," Collins Asweto, a public health expert from Great Lakes University, told IRIN.
Many of the slums are illegal, which experts say the government uses as an excuse to ignore the problem.
"Slums spring up without any approval from the government, and they will tell you they can't provide services in a place that doesn't exist. That is the paradox," Aggrey Nyange, an urban planning lecturer at the University of Nairobi, told IRIN.
Yet efforts to provide basic amenities to slum residents could result in demolitions or evictions.
"Even in the current set-up of informal settlements, demolitions will have to occur for services to be rendered, because how do you build sewer lines in Kibera, for instance? There is just no space to do it," Nyange said.
Overcrowding makes slums inaccessible, government officials told IRIN.
"A garbage collection truck cannot access many of these slums because what you have are alleys. Some people have constructed their houses on top of sewers lines, making it practically impossible to do anything about it when they get blocked," said Patrick Odongo, head of planning at the Nairobi City Council.
Meeting Kenya's target of halving the number of people without access to sanitation by 2015 will require a radical shift.
"Changing the face of Kenya's slums requires political will to do so. As a start, landlords must, as a way of policy, be compelled to build sanitation facilities before they can put any shacks in slums," Nyange said.
This report does not necessarily reflect the views of the United Nations.