52-year old Michael Agbetsoamedo resides in Ashaiman Official Town, 23 kilometers north-east of Ghana’s capital, Accra.
He works as a counsellor at the disability unit of Ashaiman Municipal Assembly (AshMA).
Like many urban slum dwellers, Agbetsoamedo, who became completely blind 30 years ago, had no toilet in his house.
He needed a guide to access the commercialized public latrine located 100 meters away from his home.
“Usually, when there is nobody in the house to assist me, I find it difficult to go to the public toilet, because the place is clumsy; I go through a washing bay, where people park cars, so I cannot go alone. And I know that all public toilets are not clean,” he said.
The imagery of feces-littered toilet floors, and stained walls, with no regular flow of water to flush the toilets and wash hands with after use, added to Agbetsoamedo’s discomfort in using the public toilet. But like many other residents, he had no choice than to pay $0.086 (50 pesewas) per visit to use the toilets.
Since the nearby facility is locked in the night, he and his household had to walk more than a kilometer to access another unappealing public toilet facility when they need to use a toilet in the night.
Ashaiman is an urban slum with an age-old problem of open defecation due to its unplanned development. There is little or no space for the construction of toilets, creating the condition for open defecation, with much discomfort for families, and some embarrassment when they receive visitors.
“I have not just heard of open defecation in Ashaiman. I have seen it before (he became blind at age 20). I have been here for 38 years, and this whole area is where people used to defecate in the open before the construction of the AshMA building,” said Agbetsoamedo.
But the turning point came in 2018, when under the World Bank-funded Greater Accra Metropolitan Area (GAMA) Sanitation and Water Project (SWP), the authorities built a biodigester household toilet for Agbetsoamedo and some other Persons With Disability (PWDs) in the municipality, under a special arrangement.
“This has cost me zero cedis. I contacted ASHMA, and although I did not have the required registration fee of Ghc 1,100 (191 U.S dollars), the managers of the project asked the contractor to build the toilets for me and some other PWDs for free,” he added with excitement.
The World Bank-financed 150 million U.S. dollars GAMA/SWP commenced in 2013 aimed at providing water and sanitation facilities, including 19,100 household and institutional toilets in deprived communities in Ghana’s capital. Beneficiary households and institutions pay 30 percent of the cost, while the World Bank finances the rest.
The project was to help end open defecation which was practiced by 19 percent of the population at the time, with its associated outbreak of sanitation-related infections, such as diarrhea and cholera. The West African country recorded its worst-ever cholera outbreak in 2014, with 28,000 cases and 243 deaths.
But now, many households are taking advantage of the GAMA project to build toilets for domestic use. The project is, therefore, helping to address the menace of open defecation, said John Armah, the Chief Executive Officer of COMSANS Ghana Ltd, a private company working under the World Bank project.
He added that the biodigester technology had become popular because, “with a small space of 7/4 feet, we can build a toilet for a household. We have built more than 5,000 potable hygienic household toilets in some of the poor communities in the capital, including the Ashaiman municipality.”
“GAMA has done a good job for Ghana, and many poor households in the capital are now applying for the toilets,” he said.
Although it was initially challenging to convince the underprivileged households to build toilets at home, through effective education on the health and economic benefits, they have bought into the idea.
“As we speak now, the level of open defecation in Ashaiman is reducing. In the past, Ashaiman had that stench of feces all over. But through this project, that unpleasant situation is reducing drastically, Armah said.
The cost of the biodigester toilets ranges between 2,500 Ghana cedis (433.4 U.S. dollars) and 8,400 cedis (1,456 dollars). It has a shallow and rectangular receptacle, made with spongy concrete slabs to aid in the biodegradation of the fecal matter lodged in it.
Regina Sangmor, a 40-year old mother of four at Adjei-Kojo, near Ashaiman, said she found the biodigester more affordable and was relieved to have a toilet at home after many years.
Muniru Issifu, a landlord at Santor in the Ashaiman municipality, with about a dozen different families resident in his apartments, took advantage of the subsidy to build two toilets for his family and tenants.
“Previously, we used to defecate in the open. I knew it was not good, and I was not comfortable with it. So when this opportunity came, I decided to build the toilets in my house. Now, we are free,” he stated.
Another resident of Ashaiman, Dora Tettevi, who has a household of 18, testified that besides the affordability of the new technology, the biodigester toilet had cut down on her daily worries, including the “high” expenditure for all her dependants to use the public latrines, “and some go twice a day.”
Due to the enthusiasm generated by the GAMA project, the demand for the biodigester toilets for households has gone up.
“A lot more people have become interested in taking advantage of the subsidies. Many also love the simplicity of the new toilet technology. So, as we speak now, we have been able to construct toilets for 30,000 households. Our target was 19,100, so we have exceeded that target,” the Coordinator for the GAMA project George Asiedu said.
Asiedu expressed satisfaction that through the hard work put into the project implementation since 2015, Ghana has started making headway in the quest to eradicate open defecation, and the country’s ranking in sanitation has been improving.
He described the GAMA project as the most well-thought-through, most comprehensive, and most successful attempt to deal with open defecation in the West African country.
Although the project was to end in December, Asiedu disclosed that the government of Ghana and the World Bank had agreed to extend it by four more years and expand it to cover Ghana’s second-largest city, Kumasi.
The success of the World Bank-funded SWP project in Accra, notwithstanding, 18 percent of the population still practice open defecation. A lot more, therefore, needs to be done to eradicate open defecation in the entire country.