While a university student, a led an open defecation education program in Cape Coast, Ghana. It was upsetting to see both parents and kids defecating at the sea shores. Not just was I concerned about their health but I was very worried about the ecological disturbance they could cause to species that habitat along the shores.

During the education program in 2014, I realized that most houses do not have toilet facilities which was the major contributor to the open defecation. However, it was also an act of ignorant by the community members as most of them did not know any consequences of open defecation on their health. Additionally, community dwellers were reluctant in using public toilet facilities due to the amount charged for using the place.

During 2015 World Toilet Day, Ghana is ranked second in Open Defecation, announced by United Nations Children?s Fund (UNICEF) – Ghana's Water, Sanitation and Hygiene (WASH) officer. It has been estimated that five million Ghanaian do not having access to any toilet facility and about 15 million people practicing open defecation – which could result from water unavailability to households in some cities in Ghana.

According to the UNICEF WASH officer, the Upper East Region of Ghana has the highest open defecation rate with 89 percent, followed by Northern Region with 72 percent and Upper West Region with 71 percent. Additionally, coastal areas in Ghana also records open defecation cases as most coastal communities lack toilet facilities and sees no harm in defecating at the sea shores. In other regions of Ghana, open defecation is recorded due to increasing number of households without toilet facilities and people failing to pay money to visit public provided toilet.

This situation is causing severe health impacts, particularly on growing children and increasing cholera and diarrhoea cases in Ghana. Sanitation issues has cost the country $79 million a year and has claimed over 200 lives, this year.

This has given rise to a major call for increase in government interventions towards provision of toilet facilities and as well the support of non-governmental organizations in the curb of this situation.