In many developing countries sanitation policy development occurs at central Ministry level, with implementation responsibility being that of the district government. The likelihood of a disconnect between policy and practice is high if the local government is not fully involved in, or has some sense of ownership of the policy development process. The situation is exacerbated if the local government officers do not feel accountable or beholden to the Ministry writing the policy. The net result may be a perfectly well written and well thought out sanitation policy being consigned to slowly gather dust in the water supply officer’s desk drawer. If the document is poorly written and un-workable, the policy document may not even reach the drawer.

In many ex-British Colony countries, the law relating to absent or poorly maintained latrines is based on nuisance abatement legislation first drafted in the UK in 1936. With the absence of any new national policy or more appropriate form of legislation, this 70 year old law is the fall back position many local government enforcement officers have to apply and rely upon to gain improvement in excreta disposal. It is simply an inappropriate and outdated form of regulation for the slum areas of cities in developing countries and is desperately in need of amendment. An example of some of the problems Environmental Health Officers face in enforcing the regulations are outlined in the box below.

The Environmental Health Officers dilemma

Mr Mkuu Hanje is the Environmental Health Officer for Temeke MC in Dar es Salaam, Tanzania. He is an experienced EHO who is reflective of the work he performs and to some extent resigned to the position he finds himself professionally.
He is reluctant to enforce the law requiring all the households to own a latrine pointing out “income is low in these areas and a latrine would cost more than the house”. Add that “to many, three meals a day is a problem, so how can you tell them to build a VIP latrine especially in squatter and unplanned areas?”
He also explained that formal enforcement procedures often run into difficulties as “landlords are hard to find or the house may be in multiple ownership, making the serving of the notice on the correct people difficult. Just being a landlord does not make a person rich, many landlords are poor as they may have inherited the property and its rent may be spilt between several relatives”

In addition to the moralistic problems there are political considerations. In theory the Environmental Health Officers are an independent authority that take action in accordance with their own judgement, taking into consideration public health risk and the likelihood of re-occurrence. In practice in Tanzania the EHOs are answerable to the Ward Executive Officers (WEO) and the Local Councillors who are acutely conscious of the wants and desires of their electorate and will usually side with private good over public good thus do not support the decision of the EHO. This results in an interesting dynamic between the EHO, the Councillor and the WEO. The EHO does not need the WEO’s permission to serve notice or to take court action, however, the WEO and councillors can make a ‘recommendation’ to the Municipal Council Director stating that a particular EHO should not be employed in his area. In such cases the EHO could be suspended and relocated, possible to a more isolated location.

Mr Hanje neatly summed up his dilemma when he stated
“ EHOs are trapped as they need to keep their political masters happy by not causing any problems and then are blamed if things go wrong such as a cholera outbreak and rubbish in the street”.