Art Madsen, M.Ed.

Throughout the small suburban village of Tsaedakristian, located west of Eritrea’s capital city, Asmara, the residents are compelled to defecate virtually anywhere due to a lack of sanitation facilities, namely private and public latrines. This constitutes a major health risk and encourages poor hygienic practices in this rapidly growing suburb of Asmara.

Because Tsaedakristian is situated only four kilometers from the capital, special sewage and wastewater problems result from the massive growth of Eritrea’s largest city. Indeed, there are a number of potential and actual hazards to human health which are impacting this town of 880 households, totaling 3,232 residents (National Statistics, 1997). These hazards can be sub-divided into two distinct categories. The first involves water contamination through seepage, run-off, direct contact with effluent, and breakdown of post-colonial plumbing and sewage systems. The second major hazard concerns the environment in general. Often, for example, there is contamination of air quality through proliferation of odors and microbial or bacterial matter.

First and perhaps foremost, in addition to obvious water quality problems, such as those enumerated above, fecal matter indiscriminately deposited threatens the integrity of household drinking water drawn from hand-pumps near open fields and footpaths. In Tsaedakristian, there are three hand-pumps, four dams and private water distribution trucks (Almedon et al., 1997). Each of these facilities can be contaminated due to poor design or location, and this is the case even for drinking water sometimes improperly stored in private dwellings. Not every household is immaculately clean, with children frequently tracking bacterial contamination and fecal matter into the home.

Secondly, turning briefly to environmental hazards, the agriculturally based economy of Tsaedakristian is also severely affected by human defecation. The fields are contaminated, as are areas surrounding the man-made reservoirs. With run-off during the rainy season, this problem is exacerbated. During hot and humid summer days, the odor becomes intolerable. Additionally, traditional beliefs favor open-air defecation in the surrounding highlands, even though many, but not all, suburban dwellers in Tsaedakristian seem to prefer indoor facilities, when available (Almedon, 1997). The same findings were noted in articles by Nyamwaya (1996) and in Shordt (1996).

The magnitude of water and environmental contamination in the suburbs of most African cities is considerable. Tsaedakristian, a small but prominent suburban area, is no exception. In fact, dysentery, gastro-intestinal ailments and intra-intestinal parasites are common among children; and these are the conditions caused by fecal contamination (WHO, 1980). More will be said about the widespread nature of this problem as our report progresses.

In this suburb, there are, statistically speaking, 12.8% of households with easy access to a safe water supply, if Tsaedakristian is a typical town in Eritrea (WSCI, 1995). Unfortunately, safe water is a rare commodity and contaminated water is relatively common.

During colonial times, Tsaedakristian was not developed by the Italian colonizer; in fact, water in 1890 was actually contaminated by them in this suburban area. The water distribution and sewage system, known then and now as MAIBELA, serving Asmara and running near Tsaedakristian was initially designed and constructed under the Italians. It was then restructured under subsequent governments, but does not, and never did, benefit or affect the people of Tsaedakristian; it serves, rather, certain agricultural interests in the surrounding area (Almedon, 1998). Included in this sewage and drainage problem from a human standpoint was, and is, a severe lack of pit-latrines and public toilets.

Realizing the scope of the risk, the Eritrean Ministry of Health, the London School of Hygiene and Tropical Medicine, and UNICEF have published extensively in the field of public sanitation in Eritrea. They focused their attention on the promotion of pit-latrines as early as 1994. Existing literature describes the types, methods and models of latrines best suited to alleviation of fecal risk factors. Maintaining of latrines is also frequently stressed in this body of literature, due to the facilities’ rapid deterioration and contamination.

There have also been Knowledge, Attitude and Practice (KAP) studies conducted in the field of pit-latrines, but they revealed essentially unfavorable insights with respect to the Eritrean people’s acceptance or rejection of such latrines (Almedon, 1998). These studies suggest ways in which to convince the public to accept these facilities, once constructed.

Ventilated Improved Pits (VIPs) are discussed in the literature, as well, and are found to be smell-free, inexpensive, non-concrete and do not require water for flushing. The technology is very simple and the literature describes the best ways to construct such VIP latrines (Cairncross, 1988; Mara, 1996; and Morgan, 1990).

The methods used to mobilize the community, raise awareness, and construct pit latrines, where necessary, include (1) identifying stakeholders, (2) generating funds, (3) assigning responsibilities, and (4) coordinating and implementing project plans through working groups and committees. In this case, stakeholders are, for example, the Minister of Health, local government officials, and community leaders. The Land, Water and Environment Ministry would also have to participate actively in coordination of the latrine construction project, inclusive of the design and building phases.

The results that could be achieved will include actual construction of approximately 400 residential latrines and at least three public latrines placed in the market and public gathering areas, such as in recreational parks. UNICEF or the Ministry of Health would be asked to contribute to the private residential latrine building effort for those families, with children, unable to afford them.

Once it is successfully implemented, the implications of such a program are vast.

Data on VIP latrines in Tsaedakristian includes material presented in Hurtado and Booth (1995). In their article, they validate the use of such accessories as ‘tippy taps’ and more effective ventilation devices than had been used in the past. The implications are important in terms of the diminishment of health risk by elimination or reduction of bacterial or microbial contaminants within the VIP latrines themselves.

To date, in the case of Tsaedakristian, many of these latrines have not been actually installed and so input, qualitative or quantitative, from other locations would be useful in predicting future trends in Tsaedakristian. For example, it has been previously seen in Zambia that such sanitation projects (either VIP, flush, vault toilets or conventional pit latrines) have proven to be relatively cheap, effective and odorless in large urban areas (Todd, 1985). Diamant (1979) also attests to the practicality of the pit latrine solution in Nigeria and agrees with most planners that this is the most suitable method for Third World nations.

When working together in small groups and in committees, it has been found that planners in Tsaedakristian have been most successful in reaching consensus on health-related sanitation issues, such as the pit latrine project. Obviously, far more needs to be accomplished, in a practical sense, and various governmental and non-governmental agencies need to be repeatedly contacted to achieve desired results. Nonetheless, once coordinated and once the public’s acceptance of it is forthcoming, this program will prove to be effective for most of the suburban communities surrounding Asmara. Its low cost and generally good results will provide support for the concept at all levels of authority. Indeed, the pit latrine represents a major factor in the reduction of fecal borne diseases and, equally important, prevents environmental contamination.


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[Art Madsen,M.Ed., Author, with Research Support from an Undergraduate Eritrean Student]