BOTORET, NAROK COUNTY, KENYA – On a cool afternoon, John Yegon puts on his jacket, grabs his walking stick and bids goodbye to his wife as he begins his daily routine of inspecting the pit latrines he has constructed for fellow villagers.

From childhood until a few years ago, the 58-year-old father of six believed that digging a hole in the ground, be it for a latrine or a grave, was taboo. That was the culture in this community 150 miles (245 kilometers) west of Nairobi, the capital. For Yegon, just like his neighbors, his toilet was the bush.

“Even up to date, there are people in other villages who still use the bush as their toilet, but I couldn’t sit down and watch my village go that direction and suffer from otherwise preventable diseases” Yegon said.

Last year, Yegon learned from a public health officer that most diseases are caused by poor hygiene and sanitation practices and mainly by open defecation. He then embarked on a mission to construct pit latrines from metal sheets and wood for his neighbors at no cost; he has built simple toilets for each of the 95 households in his village.

Siddharth Chatterjee, the United Nations Resident Coordinator in Kenya, told Civic Ideas that ending open defecation and improving hygiene and sanitation “lies at the heart of good public health” and that, without those changes, “universal health coverage will be impossible to achieve.”

A pupil washes his hands after using the toilet at Botoret Primary School. Photo by Dominic Kirui

Poor sanitation practices cost Kenya $324 million each year through pollution, cognitive damage, epidemics, deaths and other losses, according to a 2012 study by the World Bank’s Water and Sanitation Program. A recent report by World Vision Kenya, a nonprofit development organization, indicates that up to 18 percent of Kenya’s rural population practices open defecation and that 31 percent of urban and 30 percent rural people still use unsanitary or shared latrines.

“The matter of having toilets is crucial to creating a strong economy, as well as improving health, protecting people’s safety and dignity, particularly for women and girls,” World Vision Kenya’s national director, Dickens Thunde, said in the report.

Poor sanitation is a major problem in many countries; over 40 percent of the world’s population lacks access to improved sanitation, the World Vision report says. Annually, 1.8 million people die from diarrhea, mostly due to poor sanitation, and 5,500 children die each day from diseases caused by contaminated food and water, according to the report.

Botoret village is now Open Defecation Free (ODF) after certification by officials from the Ministry of Health through the Narok County Health department, which is striving to make the whole county ODF. Recently, Osentu village, in Narok West Sub-County, also achieved ODF status, according to Amref Health Africa.

Busia was the first county in Kenya to be declared Open Defecation Free, in November 2015, and, though there is still much to be done, Isiolo, Siaya and other counties have made good progress towards achieving the ODF status, World Vision reported.

Yegon took the Community-Led Total Sanitation (CLTS) approach, which the Ministry of Health recommends because it empowers the community to take care of its own sanitation. This is a no-subsidy approach in which the community receives neither materials nor cash to help construct latrines at the household level, according to the World Vision report. Instead, it evokes the community’s shame and disgust about open defecation and encourages the community to use locally available materials to construct low-cost latrines.

Even though some of the residents had toilets already, Yegon says that those were in a mess as they were not kept neat and did not have squat hole covers. This prompted him to enlist three students to help map the whole village, through which they learned every resident’s name, location in the village and number of children. That enabled Yegon to identify those who had no toilet and those whose toilet needed to be destroyed, because it was nearly full or too close to the house, and a new one built.

He says the process was not easy when he started out as some individuals would sternly refuse to have a toilet constructed for them. At times, Yegon was forced to seek the assistance of community policing officials, known as Nyumba Kumi. 

Francis Chemjor, a senior public health officer at Sogoo Health Centre, is the one who introduced Yegon to sanitation and hygiene programs. Chemjor says that he was impressed with the receptiveness of people in Botoret when he and other health officials went to the village, which is within Sagamian ward, where they work.

“Everyone in the village would practically come for seminars and, after teaching them about good hygiene practices, they all went and implemented everything we taught. It is a great village to work in,” Chemjor said.

Caritas Ngong brought the initiative to Botoret and Sogoo Health Centre as part of the Kenya Sanitation and Hygiene Improvement Program (KSHIP), whose larger purpose is ending poverty, improving health and the environment, and promoting gender equality and social and economic development. Amref Health Africa, an executing agency for KSHIP, engages Caritas Ngong and 16 other groups to implement the program.

KSHIP is a Kenya government program that is being implemented in 11 sub-counties in Kenya, among them Narok South Sub-County. It is funded by the United Nations Water Supply and Sanitation Collaborative Council and the Global Sanitation Fund, under the UN Office for Project Services

Before his transfer to Sogoo, Chemjor worked in another health center in Narok County in an area inhabited by the Maasai community, who are the majority in the county. He says that, even though the Maasai hold to their traditions, they are making significant progress on good hygiene and sanitation practices.

Among the Maasai, the elders have long considered it taboo to mix their excreta with that of women and children; therefore, digging a toilet was never an option and they would only defecate in the bush. However, Chemjor expresses optimism that Narok County will one day be declared ODF.

John Yegon inspecting one of the toilets and hand washing facilities in Botoret village, Narok County. Photo by Dominic Kirui

For Yegon, whose community is Kalenjin, it wasn’t enough to construct a toilet for every household because children faced unsanitary toilets at school. He approached the school administration with his idea to have the school toilets fitted with a water supply so that children could wash their hands. The water would come from a jerry can with a string attached and a piece of wood at the end of the string. A child could step on the wood, causing the jerry can to tip and pour water for handwashing, without contaminating the rest of the water.

Yegon has ensured that all households, the school and the church have handwashing systems, including a bottle with soap in it or a piece of soap on a string hanging next to the jerry can. There is also a locally made lid to cover the toilet and, just outside every toilet, a can of ashes and a special scoop to use in sprinkling ashes into the toilet, which reduces the smell.

Peter Tonui, a teacher at Botoret Primary School for four years, says that, since the introduction of hygiene practices at the school toilets a year ago, there have been no cases of sickness among the pupils and that has helped to reduce absenteeism.

“Nowadays, it is hard for someone walking by the road to tell that there are school toilets there because there is no smell at all, unlike (it) would be for a typical primary school toilet,” Tonui said.

Many villagers feel that Yegon was sent to save them from diseases and unhygienic practices that would bring shame to their village. Anne Yegon, a mother of six children who is not related to John Yegon, says that she has built two toilets – one for herself, her two daughters and female guests, and another for her husband, her four sons and male guests.

“Nowadays, using the toilet has become very comfortable especially with the fact that it doesn’t smell at all and also the privacy, given the nylon papers that Yegon recently came with to fit in all the toilets so that no one could see you from the outside,” she said.

Anne Yegon says that the greatest challenge now is water. Even though Botoret sits near the Mau forest, Kenya’s water tower, the women here are concerned about the steep hills that make carrying water up from the river almost impossible.

“We, however, look forward to building permanent toilet structures and so, if everyone in our village can have a water tank, we could store the rain water and never have to carry water from the river anymore,” she said.