Guinea-Bissau: Communities make their environment healthier for their children

Quinta Asuba watches over a neighbour’s baby who enjoys a bucket bath outside her home. “I took him to the health centre this week as he had diarrhoea,” she says.

Diarrhoea has been a problem in her rural community in the Western region of Biombo. Asuba now knows why it has been so bad. “We’ve been going to the toilet in the bush,” says Asuba, who has never had a toilet in her life.

Diarrhoeal diseases are one of the main causes of child mortality in Guinea-Bissau which, at 51 children per 1,000 live births dying before their 5^th birthday, has one of the world’s highest child mortality rates. If the child survives, repeated incidences of diarrhoea will lead to weight loss and malnutrition. Poor sanitation can also result in an inflammation of the small intestine, a condition called environmental enteropathy which weakens the gut’s ability to absorb nutrients, leading to malnutrition even when the child is eating enough food.  Poor sanitation also contributes to parasitic infection which young children are particularly vulnerable to, again leading to malnutrition. Untreated malnutrition during the child’s first 2 years of his or her life will mean irreversible physical and cognitive stunting. In Guinea-Bissau, over a quarter of children under the age of 5 are stunted.[1]

Fortunately, Asuba, who is eight months pregnant, will be able to bring up her baby in a healthier environment as her community has recently changed their attitudes about sanitation after they participated in Community Led Total Sanitation activities.

UNICEF supports the Community Led Total Sanitation approach during which the community members map out where they go to the toilet and their faecal-oral pathways. This low-cost approach is based on the assumption that when communities are aware that open defection means they are eating faecal particles, they will be motivated to build and use toilets even when they are not given subsidies. UNICEF also assists the Ministry of Natural Resources in the process of verification that a community is open defecation-free.

[1] MICS 2019

“Community Led Total Sanitation has proven to be an effective approach,” says Aminta Medina, the UNICEF Guinea-Bissau Chief of Water, Sanitation and Hygiene. “Guinea-Bissau is one of the few countries in the region that is on track to meet the Sustainable Development Goal (SDG) 6.2. for sanitation, that is if the current pace of 300 new open defecation-free villages per year can be maintained.”

Asuba and her fellow community members were unanimous. They all wanted to have toilets and were prepared to pay the cost of 40,000 CFA (about US$ 66) for the construction of an outdoor block of two latrines, a shower and a wash basin. 

Asuba is seeing off her niece, Arminda, 17, who is also excited about having a toilet. She is on her way to school and has just helped her aunt with the household chores which include making five trips to the well to collect water for the family. Besides the health risks, Arminda says, “I feel scared of snakes in the bush when I have to go to the toilet at night.” 

Nearby Saco Candé, the bricklayer, is doing the finishing touches to the block of two latrines that Asuba’s household of nine adults and eight children will share with her neighbour’s equally large household.

Candé is so far down the hole that he cannot peer out and seems unperturbed by the scorching midday heat. He is happy to be making a difference, “I am building a block of two ecologically friendly latrines, which will have solar-powered showers and taps,” he says proudly.

When the toilets are built, the community’s sanitation will be monitored by Joviana Jesus Embana, a health technician, who facilitated the Community Led Total Sanitation activities in Asuba’s village. She will conduct regular health promotion activities in the area, focusing on sanitation, hygiene and nutrition. “I have a passion for my job,” she says. Embana is thrilled that this community will soon be declared Open Defaecation Free and that the children, in particular, will have a chance to develop in a healthier environment.