Nature calls: Kampala’s Overflowing Toilets

KAMPALA, Uganda — For many Americans, the idea of waiting even one day to get their toilet fixed is unbearable. Last month, Florence Asiimwe, a mother of three who lives in the Bwaise Kazo zone of Kampala, had to wait six weeks. In the meantime, her family used the neighbor's facilities. On the day the latrine was finally being fixed, she said simply, "I am very happy," and went back to washing her laundry on the stoop of her small brick home.

Asiimwe's long wait will be familiar to the residents of Bwaise Kazo, one of the biggest and oldest slums in Uganda's capital city. According to the Kampala Capital City Authority, more than 70 percent of the city's 1.3 million people rely on pit latrines, or outhouses. But pit latrines fill up. It might take six months or it might take a few years, depending on where they are built, how well they drain and how many families are using them, but they will fill up. And in 2015, an estimated 10 percent will be full.

The problem is that in the overbuilt, haphazard patchwork of brick and scrap-metal houses that make up the slums, there is no easy way to empty the latrines. People make do, but not very well. There is water, but the supply is inconsistent and the slum dwellers pay ten times more for their water than do people with piped water in their homes. There are roads, but they are not paved. There are latrines, but they get filled up. Sewage removal trucks cannot navigate the narrow dirt-and-mud streets, and most people could not afford them anyway.

Hence the "Gulper," a 2-meter-long PVC and stainless steel hand pump used to empty out pit latrines. As Asiimwe does her laundry, her 2-year-old boy, David, is out back, watching as two men in blue uniforms pump out the latrine sludge into plastic canisters, which they then load onto a truck, to take to Kampala's only sewage treatment plant in Bugolobi, about a mile from the city center. The smell as they remove the sludge is nauseating, but the process appears fairly clean, all things considered.

The idea of turning sanitation into a small business in Kampala originated with Water for People, a Denver-based non-profit that brought the Gulper to the city by contracting with a local manufacturer to make and sell it. The group fosters grassroots water and sanitation projects in eight other African and Latin American countries. Water for People recruited and trained entrepreneurs who wanted to start Gulper businesses. Now the non-profit is working with the entrepreneurs to try and set up an association and certification scheme. After just one year, the businesses in Kampala are self-sustaining, or at least trying to be.

British engineer Steven Sugden, who now works for Water for People, invented the Gulper while doing research at the London School of Hygiene and Tropical Medicine in 2003. Though the manually operated hand pump is a simple piece of equipment, it has succeeded where trucks or big infrastructure have failed, and in bringing accessibility and relative affordability to sludge removal, the new technology has made sanitation available to Kampala residents like Asiimwe.

After years of working on a range of technocratic and bureaucratic schemes in community sanitation, this free-market approach of Gulper entrepreneurs seems to work best, Sugden says. "I've come to sanitation as a business not because it is the perfect solution, but because everything else I've tried has failed.

"We try and have as light a touch as possible, as we know the risks of NGO involvement screwing up the market," says Sugden. "We want to remain invisible so we can disappear completely when the market starts to mature."

John Businge, a taciturn young man, is one of 10 newly minted entrepreneurs running Gulper sludge removal businesses in Kampala. It's a dirty job, but somebody has to do it. And that's where the Gulpers fit in. Businge and his colleagues served 5,091 households last year, according to consultant Robert Makune, who works on the Gulper program for Water for People.

Businge, who previously worked in marketing for a mobile phone company, started his Gulper sludge-removal business last year, with the rather optimistic name Forever Sanitation Ltd. His business is already thriving, and he is looking to expand.

Another Gulper entrepreneur, John Doya, admits he was uneasy getting into the sanitation business at first. Doya's friends laughed at him, "but I looked at the cash flows, which seemed promising," he says, "and it has been good, and the market is still growing."

The problem so far is that for most people living in the slums, even the Gulper service is still too expensive, about $60. Asiimwe's landlord, Eddie Kizito, who lives in the neighborhood, says he had to save up money to empty the latrine. "This kind of service is too expensive for many of our people," who earn less than $2 a day, says Kizito. So "they suffer with it."

Most do figure out a way to empty their latrines for free, but it has other kinds of costs. Usually, the little brick latrines sit behind the houses, and behind each is a drainage ditch meant for storm water. Often, people remove a brick in the back of their latrine so they can then empty it into the drainage ditch, says Sugden.

"It's socially taboo to do it, but people have no options," says Sugden.

To avoid disapproval, they often do it during a rainstorm so that it will wash away, usually into another part of the village or neighborhood, where it re-enters the water supply. A study by the Kampala government of 200 wells found that all were contaminated except one.

The level of contamination in the drinking water is "almost 100 percent," says Dr. James Ssemuwemba, acting deputy director for public health and environment at the Kampala Capital City Authority.

Waterborne diseases are the major cause of morbidity in Kampala, and they overwhelmingly affect the poor, says Dr. Ssemuwemba. In the Kiswa district health center, for instance, the consequences of waterborne disease are a daily problem; worms, diarrhea, skin diseases and malnutrition are all many times what they should be, says a nurse.

The problem is that only about 5 percent of Kampala is served by a sewage system, mainly in the wealthy residential and business districts. Both the health and water ministries say they recognize the problem, but each blames the other. The result is that not much gets done.

By filling an unmet need in a creative way, the Gulper entrepreneurs have gotten the Kampala government to take notice. City officials are now considering ways of offering credit to the entrepreneurs so they can expand, and the local government is considering subsidizing the service for people who cannot afford it.

Germany and France have also given sanitation grants to the Kampala government, which now plans to increase sewer coverage to 30 percent of the city by 2040.

"That's not very ambitious, but it's a step in the right in the direction," Dr. Ssemuwemba says.