We need to get over our proper selves and start talking about diarrhea.

With the holidays around the corner it feels like every children's advocacy group is out in full force and children's issues are at the top of my mind. I've been wondering, where do children fall into the water and sanitation landscape in Kibera?

In Kibera, over 60 percent of all residents are under the age of 15 (Kenya Population and Housing Census 2009). While children's issues should always be valued and advocated for, the prevalence of "youth bulge" means youth issues should be at the forefront of the political agenda in Kibera.

Sanitation for children poses a huge threat to the wellbeing of the population. Despite the taboo against discussing defecation, diarrhea is the leading cause of death for children under 5 years old in developing countries (UN News 2014). Health efforts against HIV/AIDS, malaria, and other disease are strong, however, diarrhea is almost unmentioned. This is shocking given the reality that diarrhea is responsible for 1.5 million child deaths per year (UNICEF 2015).

I understand why diarrhea isn't a sexy cause to support, but given its potency it demands greater attention and action.

One such effort is a study that was done in the Laini-Saba Village of Kibera Slum, Nairobi. About 40,000 residents are estimated to live in the Laini-Saba Village, which is predominantly made of semi-permanent homes. 105 homes with children ages 0-5 were included in the study, accounting for 170 children within the stated age range. The study established that the rate of diarrhea was as high as 36 percent. The problem is exacerbated by poor hygienic standards for disposal of waste. The slum is affected by serious overcrowding and sanitation is characterized by overflowing latrines and open defecation. I think the most interesting finding is the strong relationship between family education and rates of diarrhea in their children (Kung’u, 2002).

Figure Above: Diarrhea Prevalence and Level of Education. Source: Diarrhea prevalence and risk factors in slums

It's possible that providing strong health education resources and sanitation education could greatly improve the rate of diarrhea in children ages 0-5 and thereby significantly decrease their mortality rate. But education alone is not enough. Sanitation issues also need to be destigmatized and the community members need to take responsibility as agents of change.

In her book, Tales of Shit: Community-led Total Sanitation in Africa, Petra Bongartz makes light of this stigma. She suggests actionable change around sanitation has to be community-led, which begins with minimization of the stigma around discussing defecation. Bongartz discusses the goal of establishing Open Defecation Free (ODF) villages discussed in the paper, "Scaling up CLTS in Kenya: opportunities, challenges and lessons (Bongartz 2010). In Kenya, in 2007 the first Open Defecation Free village was established, and by 2010 over 200 existed (Musyoki 2010).