There are several existing sanitation options in Kumasi, Ghana, but none are ideal. Open defecation is common and spreads disease, while "flying toilets" involve disposing of waste in plastic bags. Bucket latrines are enclosed buckets emptied by collectors, though some dump waste in streets. Public toilets are available but costly and unsanitary. Some households can afford pit latrines, though the waste must be emptied periodically. The municipal sewer system reaches few homes despite treatment plants, and expanding it would be difficult.

1. Existing Sanitation Options
There are a range of sanitation options in Kumasi, Ghana, though none are perfect.
The following few pages represent most of the existing options as we observed them,
in order of their desirability.

2. Open Defecation
With public toilets costing between 3 and 15 cents per use, it can be a
significant financial burden for an entire family to use them every day.
This leads many to resort to open defecation, a practice that spreads
disease and contaminates water, while also bringing shame upon the
person. We saw this more frequently in peri-urban areas or by children
in urban areas. There are generally contained areas for open defecation,
like cemetaries or areas near the public toilets.

3. Flying Toilets
To avoid the shame that comes with open defecation, or to prevent
an inconvenient trip to the public toilets in the dark of the night, many
people will use a chamber pot and empty its contents into a plastic bag
the following morning. Known as “flying toilets,” these bags are often
tossed in roadside ditches, garbage piles, or, as in this picture, waterways.

4. Bucket Latrines
A bucket latrine is a metal or plastic bucket enclosed in a wooden
box/seat, built into a small privacy room in the common area of a
multi-family compound. They’re locked to prevent use by outsiders,
and are emptied every few days by a night-soil collector from a trap-door
in the back of the privacy room. The cost of the collection services
is generally shared between the members of the compound. These
latrines were outlawed in the 1990’s because the night-soil collectors
were often dumping their contents onto the street and encouraging
the spread of disease, but can still be found in parts of Ghana. We
noticed these were more prevalent in Accra than in Kumasi.

5. Public Toilets
Originally built around markets and other public
spaces, public toilets became the norm for the
majority of urban Ghanaians with the outlawing of
bucket latrines. They’re generally blocks of 15-20
squatting stalls with minimal (if any) privacy, and
varying degrees of cleanliness. They cost between
3 and 20 cents each use, with long queues in the
mornings and evenings, and rarely with water to
wash your hands. Strips of newspaper are often
provided for wiping. For some public toilets, children
are allowed in for free. When they are not, they
oftentimes do not use the public toilets and resort to
open defecation.

6. Pit Latrines and Water Closets
Albeit few, some households have been able to save the $500-$1000
necessary to build a basic latrine in their homes. They’re generally
not much more than an underground collection tank with a privacy
shelter built overhead and a squatting/sitting toilet inside, but they offer
significant convenience and health benefits to their owners. Every few
years, though, they must empty the waste with a vacuum truck (a few
hundred dollars per tank), which takes it to the city’s landfill to dump it.
Alternative models, like the Kumasi Improved Ventilated Pits, offer
improvements like ventilation and the ability to use two tanks to turn
the waste into compost (eliminating the need for vacuum trucks) but
these require more upfront investment. Additionally, KVIP’s may not,
despite their name, be suitable for Kumasi because the soil content
and water tables in the area aren’t well suited for the design.

7. Municipal Sewer System
Although Kumasi does have a sewer system and three waste-water
treatment plants, there are only about a thousand homes connected
to it in a city of over a million residents. And, unfortunately, maintenance
is challenging for the cash-strapped government, so any plans to
expand the sewer’s reach would be expensive and difficult.

8. Thank you!
IDEO, Unilever, and Water and Sanitation for the Urban Poor
Household Toilet Project for Kumasi, Ghana
December 15, 2010
Twitter: @ghanasan
Blog: www.ghanasan.wordpress.com
OpenIDEO: www.openideo.com