We are born, we eat, we shit. And so it continues until we die. We talk about birth, about maternal health, reproductive rights. We definitely talk a great deal about food, but when it comes to faeces, there is silence. Where does it go, how is it removed, what happens to it?
We know that in certain situations the poorer you are, the more likely it is that you could die of sanitation related illness, so it is a poverty issue, a class issue. We know there are issues of privacy, access to ‘toilets’ especially at night in unlit, densely populated urban areas so it is also a gender issue. We know that some people risk physical violence or are refused entry into toilets – in Arizona there is a proposed ban where transgender people would not have the rights to choose the toilet of their choice, so it is also a transgender issue. So why is what happens to our waste so mysterious?
In 2009, the National Directorate for Water Supply and Sanitation in the Ministry of Public Works (DINEPA) was created to take control of the management of water and sanitation in Haiti. Various initiatives had been created in the past but sanitation management was close to zero.
The earthquake in January 2010 changed everything. At that point water and sanitation became a crisis issue which escalated with the October 2010 outbreak of cholera, now proved to be a direct result of human waste from a UN camp being introduced into the Artibonite River. Thousands of children were made orphans during the earthquake and more thousands have been orphaned through cholera. 8,000 people have died from the infection.
DINEPA’s role has become more crucial as it forms a major part in the management of a prevention of cholera through its camp monitoring work which falls into two areas: Data collection and municipal coordination mechanism which analyses the data regarding water supplies, number of working toilets, desludging. All of these are crucial in a country with a cholera epidemic that could get out of control at any given moment particularly as the rains begin next month.
The danger was put to me by Oliver Schulz of Médecins Sans Frontières: ‘The structures are weaker today than in 2011-12. Every year the structures deteriorate.
‘There is no plan for cholera and without a World Health Organization supported comprehensive national healthcare plan with clear directives, clear action plans and milestones then it will not get better. Also many of the big agencies have left and there are too many unknown NGOs, charities and faith groups.’
At this moment, cholera is a crisis. Access to clean water is a crisis and sanitation levels are a crisis. The refusal to see these as crisis is a major contribution to the crisis itself. To put the situation into context here is how the majority of human waste is managed.
Although the camps have the benefit of a mechanized system of desludging, the rest of the city does not. And here lies one of the problems. The post earthquake crisis has meant the focus for water provision and sanitation (as well as rape and other forms of sexual violence) has been concentrated on the camps leaving millions living in poor neighbourhood with minimal or no support.
The majority of desludging is done manually in the depth of the night by Bayakou – men who literally stand in the pits and remove the shit. Unfortunately rather than get respect for doing the worst job imaginable, Bayakou’s are stigmatized which is why they work at night. Once exposed, they are often victims of violence so very often they live secret double lives. They are often alcoholics using drink to lighten their daily tasks.
Bayakou are unregulated and no one asks where the waste goes. The government has been trying to formalize manual desludging and provide the men with proper protective clothing and regulate the disposal and to some extent this has been started in the cap. But when there is so much anti-shit bias where no one wants to discuss any aspect of shit management, it is a slow process.
Until it is ‘cool’ to brag about how my excrement is removed and treated or recycled and human waste is taken seriously as a health issue, change will be slow.