2.3 billion people around the world lack access to basic sanitation. This means that they have to defecate in open sewers, rivers, or street gutters instead of using clean toilets. These actions cause the spread of faeces around communities significantly increasing diarrhoeal diseases. Diarrhoea kills more than 1.4 million people per year, with poor sanitation, hygiene and water access (WASH) being the cause of 58% of these deaths. The World Health Organisation (WHO) has found that poor sanitation is a direct cause of over 280,000 deaths annually. In Kenya, a cholera epidemic occurs every 5-7 years and often lasts 2 or 3 years, with outbreaks of the disease occurring every single year. In 2017 there were over 4,000 cholera cases.
The sanitation crisis is particularly rife in informal settlements and refugee camps. These groups are considered the most at-risk population: high population density and inadequate sanitation facilities provide an environment that perfectly incubates disease. Kenya alone has camps housing 468,000 refuges (Sept. 2018). Political turmoil in some areas means that these refugee camps have become semi-permanent features, yet still do not have permanent, adequate sanitation infrastructure.
One of the key causes of poor sanitation is the lack of proper design in typical toilet facilities. The style that is commonly used in sub-Saharan Africa is called a 'Basic Pit Latrine', however these are rudimentary and often inadequate at preventing the spread of disease and environmental contamination.
A basic pit latrine is made by digging a hole in the ground and placing a concrete slab over over it with a hole in the middle. In many cases, the below-ground structure is often overlooked, without any supports in place or lining for the pit, which allows the waste to seep into the surrounding soil. This weakens the soil structure, and in some cases this can lead to the collapse of the pit and death. Seepage of waste has further reaching issues as well, with the possibility of the waste entering ground water sources such as wells and boreholes if built too closely. This can contaminate an entire community's water source, exposing all inhabitants to diarrhoeal diseases.
Pit latrines also provide breeding grounds for flying insects that transport human excrement onto food surfaces and people's skin.