Francois Nshimiyimana, a 39-year-old resident of Kimihurura Sector, Gasabo District blesses the day he relocated from the slums of Kamukina in the same district where he lived for four years and each day felt like an additional threat to his life.

He lived in a compound of 10 rented households that shared only one toilet and a bathroom. This, according to him, not only robs them of the needed privacy but also posed danger to people’s health.

"You can imagine the number of diseases that could be transmitted in that kind of environment because as much as people would access it one after another, there was no specific person to maintain its cleanliness on a regular basis,” he says.

The lack of adequate hygienic facilities in urban settings is mainly caused by prioritizing profit over people’s health in such a way that the landlord builds many small houses on a plot of land with less or only one sanitation facilities, says Nshimiyama.

As the world marks Global Handwashing Day on October 15 and World Toilet Day on November 19, under respective themes "Unite for Universal Hand Hygiene’’ and "valuing toilets’’, attention is brought back to investing in cost-effective approaches to address public health concerns after battling with Covid-19 pandemic.

The latest Rwanda Demographic and Health Survey 2019 indicate that 80 percent of households have access to an improved water source and 72 percent of households have access to improved latrines.

An overview shows that 88 percent of urban dwellers in Rwanda have access to improved latrines and 66 percent in rural areas, whereas one percent of urban dwellers and four percent rural dwellers lack sanitation facilities.

UNICEF defines basic sanitation as when every household has its own toilet and does not share it with another household. These toilets should also keep human waste out of contact with people.

Solange Muhirwa, Chief of Urban Planning, City of Kigali, said that the realities of informal settlements make it hard to find space for an adequate number of sanitation facilities, "reason why the government continues to upgrade such settlements to factor in the needed latrines and access to clean water.”

"Open defecation or unmaintained latrine pits cause environmental hazards which also affect human health,” she explained.

Muhirwa added that the city is considering the possibility of having free access to public toilets to facilitate those who can’t even afford the minimum charge of Rwf100 –a fee charged to cover maintenance work and hygienic supplies.

To emphasize the importance of hygiene, health experts argue that a simple act of cleaning hands can save lives and reduce illnesses by helping prevent the spread of infectious diseases mostly caused by pathogens (germs) transmitted through the air or via surfaces, food or human feaces.

This means that hands play a significant role in spreading diseases because people frequently touch their faces, food and surfaces.

A report by UNICEF and the World Health Organization themed State of the world’s hand hygiene, indicates that an estimated 2.3 billion people globally lack a facility with water and soap available to wash their hands at home, including 670 million who have no handwashing facility at all.

Facilities are also missing in many health care facilities, schools, markets, public places, and refugee camps.

"For instance, seven per cent of health care facilities in sub-Saharan Africa, and two per cent globally, have no hand hygiene services at all, and 462 million children attend schools with no hygiene facilities,” it states.

The same report shows that at least 370,000 deaths caused by acute respiratory infections and 165,000 deaths caused by diarrhoea each year could be prevented through basic hand hygiene.

Dr Edson Rwagasore, Division Manager of public health surveillance and emergency preparedness and response at Rwanda Biomedical Centre (RBC), highlighted that poor hygiene has negative implications and results in different diseases that range from common infections that affect gastrointestinal and other diseases that can lead to outbreaks such as Cholera.

He pointed out that there are continued efforts to preserve public health by increasing Ebola preparedness that is roaming in the region and other diseases.

WHO calls on governments, donors, and multilateral agencies to step up and support the fundamental of public health interventions to achieve primary health care, universal health coverage, and disease control.

Nshimiyimana who is now a father of one says that it is everyone’s responsibility to promote hygienic practices and take necessary actions in contributing to government’s efforts to increase Water, Sanitation, and Hygiene (WASH) programmes across the country.

As part of its work in Rwanda, UNICEF has provided water supply to over 600,000 people in rural areas of Rwanda in the past 10 years and is currently working in 10 of Rwanda’s 30 districts to ensure that every household has and uses a hygienic and private latrine.