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Borno State, Nigeria: Part 1 – Simple infrastructure in the combat of preventable disease

09 Jun 2017

Logistician Eric Boon reflects on his assignment working to help internally displaced people in Borno State, Nigeria.

“I wonder if you might know where the phrase, ‘shining like a beacon on a hill’ comes from? For the life of me I can't recall where I have read it. I think it was P.G. Wodehouse who described a bibulous character in one of his yarns as having a nose which "shone as a beacon”. I might be wrong about that though. Be that as it may, the example of important infrastructure depicted in the following photo “shines like a beacon on a hill”, not only because of the way the ‘ironsheet’ (as corrugated iron is known across Africa) reflects the morning sun so prettily, but because of the vitally important role which such humble architectural edifices play in the control of virulent and preventable disease.

“[The latrine] is so humble, so simple and yet so vital a link in the disease control chain"

Most people these days in the circles in which we westerners exist have never experienced the ‘long drop dunny’. In our world of vitreous china marvels, where the push of a button takes that which we no longer find useful to a destination unknown and un-sought-after, it can be difficult to comprehend just how important a simple latrine can be in the prevention of epidemic disease. But combine the practice of ‘open defecation’ with huge numbers of people crowded together, as happens with internally displaced people (IDPs), and the risk of faecal or oral disease transmission via contaminated water increases markedly.

Enter the lavatory. It is raised well above ground level, not to give an incumbent an elevated view of the scenery while engaged in the daily task but to ensure that rainy season run-off water cannot flow into the pit and overflow into the surrounding area where it may carry infection-causing organisms such as Vibrio cholerae to contaminate surface water or boreholes and wells.

The vent pipe at the rear performs an important function as well. The large diameter is important as it is designed to heat up in the sun and establish a convectional flow of air which aids in the dispersal of noxious gasses and in fly control. Médecins Sans Frontières tends to build a multiple stand design as it is more cost effective to dig a large hole rather than several smaller ones. It can be divided and usage alternated to allow evaporation as well. We also provide access for "desludging" (as it is known). It cannot be stressed too strongly just how important the latrine is as a first line weapon for disease control. It is so humble, so simple and yet so vital a link in the disease control chain.”