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DEFEACATION
Oludoyinmola Ojifinni
Community Medicine Department, University College Hospital, Ibadan, Nigeria
oludoyinmola@yahoo.com
Introduction
Indiscriminate urination and defeacation occurs when people go against safe sanitary practices
in excreting these normal human wastes. According to some experts, it is advisable for every
human being to bring out excreta or defeacate at least once every day. Freeing of ones bowel
is a good habit, and is good for health. However, disposing of it carefully and responsibly is the
central idea. Some factors found to be responsible for this practice include indiscipline, poverty,
nonexistent or poor enforcement of laws regulating building standards, inaccessibility of toilet
facilities in public places.
Indiscriminate urination/ defeacation are particularly significant when it occurs where there is a
high likelihood of contaminating water supplies or the food chain. Such areas include;
Agricultural land planted with crops, particularly if the crops are soon to be handled or
harvested for human consumption. This also involves fields where livestock regularly
graze.
These issues are of particular concern in low- and medium-income countries, contributing to
disease transmission; this is due to a lack of adequate and appropriate sanitation and hygiene
access. An estimated 2.6 billion people lack access to adequate sanitation globally. If the
current trend continues, by 2015 there will be 2.7 billion people without access to basic
sanitation. The regions with lowest coverage are sub-Saharan Africa (31%), southern Asia (36%),
and Oceania (53%). Underlying issues that add to the challenge in many countries include a
weak infrastructure, an inadequate human resource base and scarce resources to improve the
situation. Nigeria falls amongst the worst performing nations with millions of its population
without access to basic sanitation and drinking water. Thirty four million Nigerians- more than
the size of any of the nations six Geopolitical zones - are without toilets, and still practice
open defeacation.
Also indiscriminate defeacation/ urination usually increase significantly in emergency situations
and in refugee camps and constitute the main health hazard in such situations. People affected
by a disaster still need to defeacate, they will attempt to follow traditional practices, but if that
is not possible, they will defeacate wherever they can.
The public health implication of indiscriminate urination/ defeacation stems from the role these
human wastes play in the transmission of a whole range of diseases of public health
importance. According to some experts, human excreta contain 400 different species of
bacteria and viruses. With the presence of these pathogens in the environment, surely there
will be no doubt that foods and drinks would be contaminated either directly or indirectly. The
end results of contaminated foods and drinks are usually associated with diseases such as
typhoid fever, cholera and diarrhoea.
through the skin and mucous membranes). For the purpose of this brief, a combination of both
will be employed;
1) Viral
Poliomyelitis (poliovirus)
2) Bacterial
3) Protozoal
Cryptosporidiosis (Cryptosporidium)
4) Helminthic
Trichuriasis
(Trichuris
trichuria),
vermicularis).
Enterobiasis
(Enterobius
Rotaviruses
Diarrhoeal diseases, as a group, remain a major cause of death in developing countries,
especially preschool children. Children under 3 years of age may experience as many as 10
episodes of diarrhoea per year. Rotaviruses are the most common cause of diarrhoea
worldwide, accounting for 134 million episodes yearly. Virtually all children have been infected
by the age of 4 years.
Cholera
This is a highly infectious disease of rapid onset characterized by vomiting; profuse
dehydrating diarrhoea with rice water stools and marked toxaemia. It is caused by bacteria
named Vibrio cholerae. These bacteria cause not only epidemics, but are responsible for
several pandemics. It is strongly related to the use of polluted water for irrigation or to unsafe
disposal of sludge and excreta. Major risks occur where there are large concentrations of
people and hygiene is poor (as in refugee camps and urban slums).
Amoebiasis
Amoebiasis is caused by the protozoan Entamoeba histolytica. The parasite lives in the large
intestine causing ulceration of the mucosa with consequent diarrhoea. It has a worldwide
distribution, but clinical disease occurs more frequently in tropical and subtropical countries.
In certain areas of Africa, Asia and Latin America, the prevalence of asymptomatic infections
ranges from 5% to more than 80%. Recent estimates suggest that 500 million people per year
are infected with E. histolytica and approximately 8% will develop overt disease. Also, 40,000
100,000 deaths per year are attributable to invasive amoebiasis. Globally, amoebiasis is the
third most common parasitic cause of death after malaria and schistosomiasis.
Schistosomiasis/ Bilharziasis
This is caused by a water-based trematode. It affects approximately 246 million people
worldwide, causing tens of thousands of death every year, mainly in sub-Saharan Africa. It is
strongly related to unsanitary excreta disposal and the absence of nearby sources of safe
water. It is the most widespread of human parasitic worm infection, ranking second only to
malaria in terms of its socio-economic and public health importance in tropical and subtropical
areas. Direct mortality is relatively low; but the disease burden is high in terms of chronic
Conclusion
Indiscriminate urination and defeacation is clearly a public health issue of significant
proportions considering its prevalence globally and especially in developing countries like ours.
The significant contribution it thus makes to the transmission of quite a number of infectious
diseases of public health importance cannot be overlooked.
It can then be inferred that any measures capable of reducing indiscriminate urination and
defeacation will significantly improve health status and thus reduce mortality and morbidity
globally especially in low- and medium- income countries.