More Nigerians have access to mobile phones than toilets.

In humanitarian circles, that line has become clichéd, used as a jarring comparison to highlight how something that’s taken for granted in many countries remains outrageously out of reach in Nigeria.

But the comparison elides a key point — providing adequate sanitation throughout Nigeria is a gargantuan task, requiring billions of dollars in investments, an overhaul of infrastructure, and widespread support across all levels of society.

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Across Nigeria, 123 million people, or 7 in 10, do not have access to a decent toilet. Millions of people are forced to defecate in the open, in ditches, rivers, or elsewhere, exposing themselves to infection and sexual violence in the process. More than 59,500 children under the age of 5 die each year because of poor water and sanitation.

These stats come from WaterAid, an international nonprofit that works to improve access to water and sanitation (WASH) around the world.

In recent years, WaterAid, led by the country director ChiChi Okoye, has reassessed its role in Nigeria.

“WaterAid has had quite a shift in its approach,” Okoye said. “We started off by trying to provide services to communities, putting in water and sanitation facilities, but Nigeria is a large country and we figured out we could do it for a thousand years and we wouldn’t scratch the problem. So we shifted to influencing — trying to get the government to do its civic responsibility.”

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“The government has 10 times more money than we do, and is a primary organ for providing services to people,” she added.

WaterAid noticed that the community toilets being built by the government often fell into disrepair within a few years because of the lack of resources and trained custodians needed for maintaining them.

To make matters worse, there were no official standards for new toilets.

“In the past, you could have toilets that were really tiny or very big, and toilets without capacity for people with disabilities,” Okoye said.

As a result, improving sanitation access in the country became like a game of whack-a-mole. When one community received improved sanitation facilities, construction teams would move onto another village, only to have to return to the original village to build a new facility a few years later.

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The problem has been made worse by increasing urbanization, according to Deutsche Welle. More than 20 million people are crammed into the megacity Lagos, and people living in the poorer neighborhoods on the city’s outskirts often have no access to sanitation infrastructure.

Okoye said that rather than building new toilets, WaterAid now focuses on educating people about sanitation and hygiene, creating standards for new toilets, expanding government capacity for overseeing sanitation issues, advising the government on new laws, and creating opportunities for private investments.

Programs to improve sanitation often fail because of a lack of campaigns that promote behavioral change at both the local and institutional level.

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“We’re building the capacity of government because the World Bank found that [many] water schemes put in place by the government break down within one year,” Okoye said. “That tells us that the material support and technical expertise to do the work is negligent.”

“Many of the schemes don’t put into place sustainability structures, managerial structures, and many times they’re built without the knowledge and collaboration of communities,” she added. “So people wake up one day and a toilet’s being built.”

Nigeria recently had a major election that could have altered the country’s progress on WASH, simply by installing new leaders with new priorities, but Okoye said that many key sanitation champions won their races.

"We need to talk about the solutions alongside the problem and we're glad to have stakeholders from government, private sector and development partners in the room. Together we can tackle Nigeria's WASH crisis." - @chichiaokoye@PINDFoundation@_NDLinkpic.twitter.com/tcE1APSeSf

— WaterAid Nigeria (@WaterAidNigeria) March 20, 2019

WaterAid also ran an election campaign called Vote for WASH that called on politicians to sign a pledge to improve WASH conditions.  

“Luckily some of the really prominent politicians from those states were able to sign,” she said. “We’re happy to announce that a majority of them won their elections.”

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Okoye hopes that WASH issues will be prioritized across government agencies in the years ahead.

“In Nigeria, the focus on health is really not on prevention — it’s on cure,” she said. “The response to health challenges is to build more hospitals, but that’s to the detriment of preventive things like WASH. So it’s not uncommon to go to health facilities that have no water, and no adequate toilets.

“A lot of ministries work in silos,” she added. “People in education aren’t looking at school drop-out rates and [connecting it to] WASH, and then talking with the ministry of health and water resources.”

Access to clean #water is a basic human right and should be normal for everyone, everywhere.

Sadly, nearly 60 million Nigerians live without this basic need. This is unacceptable and totally preventable. #WorldWaterDay#LeaveNoOneBehind@PINDFoundation@_NDLinkpic.twitter.com/daY2lO7AUx

— WaterAid Nigeria (@WaterAidNigeria) March 20, 2019

Part of WaterAid’s efforts involve breaking down these silos so that, for example, when new schools are built, they have clean drinking water and working toilets.

The organization is currently focusing on three states in the center of the country — Bauchi, Enugu, and Plateau. State governments in Nigeria have enormous budgets and political power and can therefore create immediate change on an issue if the motivation is there. In the past, government corruption and a lack of attention to WASH has impeded progress.

In Bauchi, Okoye’s team is making sure the government has capacity to build standardized toilets and sanitation infrastructure and then track progress afterwards.

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They’re also helping to change how communities are informed of projects. Traditionally, men have been invited to learn about a new system and how it can be maintained, while women have been left in the dark.  

“But it’s women who fetch water, so when you find that a man has been trained and he’s moved away from the community, or he’s just not available, the women have to wait, and cajole, and plead,” Okoye said. “But if it’s the women themselves who are trained to maintain it, then the chances are those facilities will work for longer.”

But people have been very open to participating in community initiatives to improve community sanitation, she explained.

“A lot of people where we work are feeling vulnerable, a lot of people depend on rivers that are polluted, or on rainwater,” Okoye said. “WASH is a basic necessity. It’s not like we’re trying to change a person’s religion.”