Uganda's (Preventable) Mess

September 12, 2014 | Pulitzer Center

Sam Loewenberg

Nabirya Haddija said that four of her nine children are receiving medication to prevent schistosomiasis. She tells the children to stay away from the waters of Lake Victoria because of the risk of infection. Image by Samuel Loewenberg. Uganda, 2014.

Chrispus Oguti oversees a solar-powered water pump put in by the missionary organization Water Missions International. Before the village had access to clean water, "we were really suffering" said Oguti. Image by Samuel Loewenberg. Uganda, 2014.

Irumba Hakim, is a fisherman who also volunteers as a health worker to combat the many diseases that plague his town. His daughter Kaahwa, 4, has schistosomiasis. The health work is time consuming, says Hakim, and the workers should be paid. Image by Samuel Loewenberg. Uganda, 2014.

Community health worker Christine Mbabazi says that people in her village suffer from a range of waterborne diseases, including diarrhea, malaria, scabies, trachoma, and schistosomias. Image by Samuel Loewenberg. Uganda, 2014.

In the village of Bwondha on the shores of Lake Victoria, people's lives center around water. It is used for drinking, washing, watering animals, and often, as a bathroom. Image by Samuel Loewenberg. Uganda, 2014.

In the town of Walumbe, Uganda, a sign warns against contact with Lake Victoria, home to the sanitation-related illness schistosomiasis, a disease of parasitic blood flukes. Image by Samuel Loewenberg. Uganda, 2014.

Only five percent of Uganda's capital city is linked to a sewer system, most of which serves the wealthy elite. Image by Samuel Loewenberg. Uganda, 2014.

Kampala's city government is leading an effort to provide sanitary services to poor communities. "We need to sensitive the rich that the health of the poor matters to them," said Godfrey Kisekka, Town Clerk for the Nakawa division. "Disease has no borders." Image by Samuel Loewenberg. Uganda, 2014.

A new device, the Gulper, can remove sludge from pit latrines in slums, which are otherwise inaccessible. Many of Kampala's urban latrines are filled up and no longer useable. Image by Samuel Loewenberg. Uganda, 2014.

Steven Sugden, the Global Technical Director for the NGO Water for People, developed a device known as the Gulper to remove sludge from urban pit latrines. Normally, people are forced to empty their latrines in rain gutters. "It is socially taboo to do it, but people have no options," he said. Image by Samuel Loewenberg. Uganda, 2014.

The level of contamination in the drinking water is almost 100 percent, according to the city's department of public health and environment. Image by Samuel Loewenberg. Uganda, 2014.

Ninety-five percent of the city's population is not connected to the sewer system, and nearly all of the water supply is contaminated. The result is that waterborne diseases are the major cause of morbidity in Kampala, and they overwhelmingly affect the poor. Image by Samuel Loewenberg. Uganda, 2014.

Uganda is in a sanitation crisis, one that affects the country's health in the most fundamental ways. One consequence is that thousands of people suffer from schistosomiasis, a neglected disease that affects the poor. It is directly related to Uganda's poor sanitation—about two-thirds of the populace does not have access to improved sanitation facilities.

This is a preventable problem. International aid agencies and development banks are working with government to expand the sewer systems, while NGOs are working with local entrepreneurs as well as international companies to find ways to make the existing pit latrines safe and sanitary.