Abstract

Background: In 2004, the WHO burden of disease report established that infectious diseases caused by lack of water, sanitation and hygiene lead to 18,300 deaths per year in Cameroon, and accounted for 13.4% of the burden of disease in the country. Public toilets in Buea are still a call for concern with few existing, in bad shape. Sanitation necessary for healthy living which is supposed to ameliorate the situation for pressed-up persons is virtually absent.

Public joints like markets, drinking spots, public offices, schools and even Churches lack good toilets where the people can relieve themselves. Where toilets exist, they are left in very bad shape and instead served as breeding grounds for vectors of diseases that are easily transmitted to users. Most of the toilets especially in the aforementioned areas are broken down with no water to flush after use.

Therefore, it is against this background that this study sought to assess the accessibility, availability (since inaccessibility is presupposed availability) and management of public toilets in Buea Municipality and the health consequences on the users. For this work to be realized, a Cross-sectional study was carried out in some randomly selected areas in the Buea.

This was a mixed method study design; quantitative data were collected using structured questionnaires whereas the qualitative data was collected with the aid of focus group discussion and an in-depth interview guide.

For the quantitative data, a total of  384 study participants were interview while for the quantitative data five groups of focus group discussion was organized to have the opinion of participants, on the accessibility, management of public toilets and the health consequences until a saturation point is attained with composition of a focus group discussions.

Findings revealed that public toilets were available and accessible to the general public. It was also revealed that the condition of most of the toilets was bad. In addition, it was discovered that locating the toilet was difficult as proper signposts were not in use.

Deterrents to users of the public toilets include a dirty environment, odour, flies and poor ventilation. The lightning of the toilets was generally poor and did not ensure the safety of users at night. There were no hygiene education posters at the toilet sites and the caretakers also lacked training and tools needed in the management and maintenance of the public toilet facilities.

Due to poor hygienic practices, both users and caretakers were susceptible to infectious diseases such as Vaginal yeast, Gonorrhea, rashes, Bacterial vaginosis and Cholera. It is further observed that privately managed public toilets were cleaner than those managed by the Buea Council. In line with the findings, the study recommends regular monitoring of the toilet facilities to ensure conformity with the national standards and guidelines of public toilet provision.

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