A hole lot more than just a toilet

CARE builds new toilets in Malakal, South Sudan

In a humanitarian crisis such as the one currently unfolding in South Sudan, it is food, water and safety that are usually considered the essentials for survival. Yet as the world marks World Toilet Day (19 November), CARE's Tom Perry discovers that the humble toilet is also changing – and saving – lives in the world's youngest nation.

With the growing Ebola epidemic in West Africa now dominating global headlines, the crisis in South Sudan – only a few months ago labelled 'the world's worst humanitarian crisis' – has sadly slipped from the headlines and out of many people's minds.

Yet, across the world's newest nation, the response work continues. An estimated 1.5 million people remain in urgent need of food and nutrition support, and aid workers operate in extraordinarily challenging conditions, helping to provide medicine, food and safety to hundreds of thousands of people across the country.

An essential basic need

There is one part of the response that many would argue remains as essential as medicine, food, water and security yet goes unheralded; bringing dignity, sanitation and ultimately, protection from potentially fatal disease outbreaks: the construction of emergency toilets.

Access to safe toilets is particularly vital for women so they don't have to travel out in to the forest where they can be at risk of harassment or sexual violence.

Terrible conditions

"People were faced with awful, awful conditions," said Kilong Alex Noel, a member of CARE's Water, Sanitation and Hygiene (WASH) team who has spent most of this year working in and around Malakal, one of South Sudan's largest urban centres in the country's far north.

Following the outbreak of fighting late last year, much of the population of Malakal sought refuge in villages out of the immediate reach of soldiers and gunfire, or inside the UN's hastily-built Protection of Civilian site, set up in what is effectively a giant swamp, and one that was never designed to cope with the extraordinary number of people that have sought refuge there.

"People really needed help," said Alex.

They've been forced to live in the mud, without dignity, with very little support for the basic human need of hygiene.

Women, children, fathers and mothers had run to the UN site seeking safety from the fighting, yet when the battles raged in December, January and into February, family after family found themselves building makeshift homes inside swampland that had very little natural irrigation. The smell of faeces was all-pervasive. Toilets were hastily constructed, yet provided no proper sanitation, no privacy, and many soon collapsed.

Constructing emergency toilets

"We first constructed 112 emergency toilets," explained Alex. "They were built quickly, but realistically weren't able to cope with the huge number of displaced people coming in each day to the site. These latrines were without lining, they were built only with simple sheeting; sheeting that was meant to stop the soil from collapsing."

The arrival of the rainy season downpour quickly reduced many of the hastily-built emergency toilets to piles of rubbish, mud and filth.

"When the rains first came to Malakal, [they] all collapsed and we were back to square one," said Alex. "It was an awful situation."

Alongside a number of other aid organisations, Alex and other members of CARE's team went to work designing and constructing toilets that would help provide dignity, safety and, importantly, better protection from potentially fatal diseases such as cholera.

The pressure was really on us. We needed to move quickly, to help families cope, and to help prevent the outbreak of diseases.

He said he and the team needed to think quickly – but think creatively – in order to create a solution that would be able to cope with the extraordinarily difficult conditions in Malakal, yet one that would be cheap enough to build in the hundreds.

"Ideally, latrines are to be lined using bricks or cement, or even concrete in order to protect the soil from collapsing. But we're operating in an emergency situation, without access to most materials. You cannot get bricks or sand here."

"And the soil in Malakal is called black cotton soil, which is clay and highly-collapsible and it becomes soft when it gets wet," explained Alex. "During the dry season, it cracks, then when the rains come, it just collapses."

CARE gets to work to find a solution

After a number of long days and late nights of planning, testing and re-testing their ideas, the team from CARE then got to work digging deep pits, six metres wide and nearly four metres deep, before constructing timber frames inside that would ensure the toilets would then retain their structure in the highly-collapsible soil they were sitting inside of.

A clean-up effort was launched, with hundreds chipping in to make the Malakal site liveable again, and bringing clean water and safe conditions to a location that had become a sanitary nightmare. Within weeks, the team had dug, engineered and constructed hundreds of new latrines inside the Malakal camp, with a design that has received widespread praise and has now been replicated in other parts of the country.

And some months on, despite torrential rains and flooding inside the camps, the new toilets have retained their structure, to the clear relief – and quiet pride – of CARE staff such as Alex.

"The situation people are living in places like Malakal is very difficult," said Alex. "The Protection of Civilian sites are awful places to be in, yet what's outside is likely much worse, and that's why people are still there.

What we're doing is giving people some dignity, safety and protection from disease. It is important work.

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News and stories are provided by CARE staff working to support our emergency responses and long-term development programmes.