... as in literally.
The report goes on to say that the sewage handling facilities, designed for a population of 50,000, has been operating over 3 times it's design capacity, serving over 190,000 residents. And it's hazardous potential to the nearby residents had been highlighted as far back as 2004 by UN aid agencies.
When you gotta go, you gotta go. That's one of those inevitable realities in life, like taxes. But certainly not this way.