Nasoro Primary School is right at the centre of Gumel town in Jigawa State, North West Nigeria. It has over 4,700 students and 78 teachers, according to Arma Muhammed, the head teacher. At 11am on a Thursday morning, the timekeeper stood in the school playground and rang his bell, signalling the break time. Students from different classes emerged simultaneously, with many running towards water taps in front of a water tank in the middle of the school, as teachers filed them into queues. Each student carried a small container which they used to fetch water. "You can see how happy they all are", says Muhammad as he joined other teachers in organising the students. "Previously we had only two hand pump boreholes which were not enough. Now we have 15 running taps," he added.
The primary school is one of the 20 schools that received Water, Sanitation and Hygiene (WASH) facilities in Gumel Local Government Area (LGA), under the Water Supply and Sanitation Reform Programme (WSSSRP). The program is supported and funded by the European Union (EU) in partnership with state governments and runs in selected LGAs in Jigawa, Kano, Yobe, Osun, Anambra and Cross River states. The programme aims to build technical capacities of the state governments in providing efficient WASH services and improving access to the services especially in rural communities. The WASH facilities constructed under the programme include solar-powered underground boreholes, hand pump boreholes, latrines, urinals and handwashing facilities. These were provided in communities, primary and secondary schools, and primary health centres (PHCs).
WASH services have greatly improved at Nasoro primary school. The newly built six toilets by WSSSRP have allowed the teachers in the school to have their own conveniences separate from their students'. The toilets were divided equally, with three each for male and female teachers. However, students still have to use the old 30 pit latrines, which could pose risks to their health. Authorities of Gumel LGA should consolidate on what WSSSRP has done by rehabilitating the toilets, so that WASH services would be optimal in the school.
WASH in health facilities; A critical need
Mukhtar Muhammad, the WASH Coordinator at Gumel LGA, said five PHCs were provided with sanitation facilities and hand pumps, and 190 hand pumps were installed in rural communities across 11 wards of the LGA. Zango PHC, a few kilometres away from Nasoro Primary School, is one of the benefiting primary health centres. Babandi Ahmed, the Facility-in-Charge, said the PHC previously had three toilets inside the main building for use by staff and patients, which were inadequate because of number of patients they see daily. The smell that came out of the toilets was a problem for staff and patients, and most patients did not want to enter the toilets, so getting stool and urine samples was not easy. The PHC's only source of water, a hand pump borehole, had also been non-functional for years, making procedures such as childbirth difficult as water had to be bought.
Zango PHC now has six toilets, three for males and three for females. They were built by the WSSSRP outside the main building in 2018, in addition to three urinals and two handwash sinks. The existing borehole was also fixed. "Now we have privacy, especially for our female patients," Ahmed said, adding, "When we need samples, patients comfortably enter the toilets to get them. Women coming for antenatal also don't have to worry about easing themselves."
He said the water problem is not completely solved though, as the hand pump borehole breaks down occasionally, forcing them to still buy water outside. The toilets also have no pipes that lead water directly to them, and this is a challenge whenever the borehole is down. WSSSRP and other projects on WASH should equip toilets with water piped directly in subsequent interventions.
Accelerating access to WASH for the girl-child
The town of Kachako in Takai LGA of Kano State is home to Government Girls Unity Secondary School, an all-girls boarding school with over 1300 students from all 19 Northern Nigeria states. The school had 38 toilets of which only 18 were functional in the past. "The toilets we had were not connected to water and some were attached to the dormitories and classrooms, causing unbearable smell for the students and teachers" said Aishatu Tukur, the school Principal. The two existing hand pump boreholes were not enough for the students, and they were continuously needing repairs.
That has changed, with the construction of three solar powered boreholes, each connected to an overhead tank and four taps, under Kano State's WSSSRP Programme. One of the tanks was built close to the students' hostel so that the young ladies could always have access to water. A total of 24 toilets were also constructed in the school, with 12 close to hostels and 12 close to classrooms. In addition, 18 urinals and six handwash facilities were built, evenly distributed. The students now comfortably enter the toilets when they need and because water is always available, and the toilets are constantly being cleaned. "Hygiene has improved tremendously" Ahmed said, "The students are always neat now and we have seen a reduction in cases of students falling ill going down tremendously". However, like Zango PHC, all the newly built toilets have no pipe-borne water leading directly into them, and students and teachers have to go in with their water in buckets.
Providing water in rural communities
Further south in Kano state in Madobi LGA is Galinja village. Residents here used to walk two kilometres to get water from the same river their animals drink from, village head Malam Alhassan Yahaya said. He adds that children in the village sporadically developed skin rashes and experienced bloody urine, a likely case of Schistosomiasis. Galinja now has an underground solar powered borehole with a 12,000-litre overhead tank and taps to serve as sources of water for the village. Underground pipes connected to the tanker were also laid in various neighbourhoods so that interested households can have their own individual taps. The Head of the EU Delegation in Nigeria, Ambassador Ketil Karlsen, commissioned the project in September 2019.
Yahaya said women and children no longer walk every morning to get water, and most importantly, cases of skin rashes and bloody urine are disappearing. He however adds that no household has been able to take advantage of the reticulated pipes to install their own taps. As it stands, everyone in the village gets water from the four taps attached to the tank and he fears that they could break down. To mitigate that, the Water Consumer Association which was formed to ensure good usage and maintenance of the water facility, introduced a system for the taps to open for use between 6AM to 10AM in the morning and 4PM to 7PM in the evening. There is also a plan to introduce a levy of five Naira for every 25 litre jerrycan of water or equivalent. The money will be used for maintenance of the water facility.
A long road ahead
Lack of access to WASH is a major contributing factor to various deadly infectious diseases like cholera which kills more than 70,000 under five children in Nigeria every year, according to UNICEF. The United Nations estimates that globally, 2.2 billion people lack standard water services and 4.2 billion people do not have a sanitation facility that safely dispose faeces. Not only in communities, places like schools and health facilities especially in rural areas face the challenge of inadequate, equitable and gender-sensitive WASH services. A 2019 joint WHO/UNICEF report showed that worldwide, 896 million people use health care facilities with no water supply and 1.5 billion use facilities with no sanitation services, with Nigeria among the countries where more than 20% of health care facilities had no water or sanitation services as at 2016.
These challenges expose those working in the facilities and their patients to threats of infectious diseases. It is also highlighted by UNICEF that one in four primary schools globally have no safe drinking water service; one in five primary schools and one in eight secondary schools have no sanitation services. This is despite the evidence that availability of WASH services in schools strongly improves education outcomes for both boys and girls.
Nigeria is currently responding to the COVID-19 outbreak, and one of the constant advisories from government and experts is that people should wash their hands frequently with soap and running water. With over 20% of our health facilities lacking access to water and sanitation services, and only 31.4% with access to basic handwashing facilities, the incredible importance of WASH in preventing the spread of infectious diseases has come to light. It is critical for partnerships to improve WASH facilities to be encouraged across the country.
Do you know other states where partnerships have increased access to WASH services? Let us know in the comments or on our social media platforms: @nighealthwatch on Twitter and Nigeria Health Watch on Facebook.